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General NPI Number Information
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NPI Number | 1851691083
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Entity Type | Individual
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Provider Name | ROBERT MORAN MSN, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 1501 E BUSTAMANTE ST STE D
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City | LAREDO
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State | TX
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Zip | 78041-8905
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Country | US
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Telephone | 956-235-1056
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W HILLSIDE RD # 1
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City | LAREDO
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State | TX
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Zip | 78041-3141
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Country | US
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Telephone | 956-235-1056
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 630856
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 630856
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License Number State | TX
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