MEDICARE: MONTES MORENO HEALTHCARE ASSOCIATES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1033954177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTES MORENO HEALTHCARE ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	5245 WALZEM RD
Second Line	:
City	:	WINDCREST
State	:	TX
Zip	:	78218-2122
Country	:	US
Telephone Number	:	210-654-9700
Fax Number	:	210-660-1414

Provider Business Practice Location Address
First Line	:	5245 WALZEM RD
Second Line	:
City	:	WINDCREST
State	:	TX
Zip	:	78218-2122
Country	:	US
Telephone Number	:	210-654-9700
Fax Number	:	210-660-1414

Authorized Official
Title or Position	:	OWNER
Name	:	YANDI MONTES DE OCA MORENO
Credential	:	APRN-CNP
Telephone Number	:	210-654-9700

Provider Enumeration Date	:	06/29/2024
Last Update Date	:	03/03/2026

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