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General NPI Number Information
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NPI Number | 1851646012
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Entity Type | Individual
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Provider Name | SANDY M MORAN BACHELORS DEGGRE
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Gender | Female
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Dates
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Enumeration Date | 07/13/2012
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 14515 BRIARHILLS PKWY STE 208
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City | HOUSTON
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State | TX
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Zip | 77077-1034
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Country | US
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Telephone | 917-833-6446
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Fax |
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Provider Business Mailing Address
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Address Line | 21550 PROVINCIAL BLVD APT 1603
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City | KATY
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State | TX
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Zip | 77450-7576
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Country | US
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Telephone | 646-453-9368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2355A2700X
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Taxonomy Name | Audiology Assistant
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License Number | 39393
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License Number State | TX
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