MEDICARE: JOSE MORALES

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	225200000X	Physical Therapy Assistant	2052040	TX

General Provider Information

NPI Number	:	1427461359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE MORALES

Provider Business Mailing Address
First Line	:	709 ANGELITA DRIVE
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78596
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	709 ANGELITA DR
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78599-5281
Country	:	US
Telephone Number	:	956-854-4325
Fax Number	:

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

Provider Enumeration Date	:	06/09/2014
Last Update Date	:	06/09/2014

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