MEDICARE: DR. DAVID SAUL MORA O.D.

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	152W00000X	Optometrist	3202TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255305256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SAUL MORA O.D.

Provider Business Mailing Address
First Line	:	1601 CORPUS CHRISTI ST
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78043-3302
Country	:	US
Telephone Number	:	956-726-1007
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 CORPUS CHRISTI ST
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78043-3302
Country	:	US
Telephone Number	:	956-726-1007
Fax Number	:

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	06/01/2011

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