MEDICARE: DR. TIMOTHY PATRICK MORAN 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	206768	LA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	T3340	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	206768	OTHER	LA	STATE LICENSE

General Provider Information

NPI Number	:	1639313513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY PATRICK MORAN M.D.

Provider Business Mailing Address
First Line	:	10490 HUFFMEISTER RD STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-5654
Country	:	US
Telephone Number	:	832-280-5447
Fax Number	:

Provider Business Practice Location Address
First Line	:	10490 HUFFMEISTER RD STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-5654
Country	:	US
Telephone Number	:	832-280-5447
Fax Number	:

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

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	01/29/2025

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