MEDICARE: ANA MORALES-AMAYA M.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	207VG0400X	Gynecology Physician	K8356	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0019ZD	OTHER	TX	BLUECROSS & BLUESHIELD PIN

General Provider Information

NPI Number	:	1619979903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA MORALES-AMAYA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1261
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77549-1261
Country	:	US
Telephone Number	:	832-619-1373
Fax Number	:	832-619-1378

Provider Business Practice Location Address
First Line	:	359 E PARKWOOD AVE
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5147
Country	:	US
Telephone Number	:	832-619-1373
Fax Number	:	832-619-1378

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/13/2016

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