MEDICARE: MELISSA L MORENO PA

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	363A00000X	Physician Assistant
2	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1114030681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA L MORENO PA

Provider Business Mailing Address
First Line	:	8426 SPRINGFIELD GORGE DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78681-3543
Country	:	US
Telephone Number	:	512-582-2388
Fax Number	:

Provider Business Practice Location Address
First Line	:	8426 SPRINGFIELD GORGE DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-3543
Country	:	US
Telephone Number	:	254-258-4649
Fax Number	:	315-772-9498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	02/05/2025

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Directions to “ MELISSA L MORENO PA” Practice Location

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