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General NPI Number Information
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NPI Number | 1770555971
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Entity Type | Organization
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Legal Business Name | MORAN EYE CENTER PC
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 2001 HAMILTON BLVD STE D
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City | SIOUX CITY
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State | IA
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Zip | 51104
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Country | US
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Telephone | 712-252-4333
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Fax | 712-252-1633
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Provider Business Mailing Address
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Address Line | 2001 HAMILTON BLVD STE D
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City | SIOUX CITY
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State | IA
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Zip | 51104
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Country | US
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Telephone | 712-252-4333
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Fax | 712-252-1633
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Authorized Official
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Title or Position | DOCTOR PHYSICIAN
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Name | MR. TIMOTHY F MORAN JR.
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Credential | MD
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Telephone | 712-252-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 19909
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25860
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License Number State | IA
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