MEDICARE: DEVIN MORENO

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	171100000X	Acupuncturist	AC01724	TX
2	171100000X	Acupuncturist		TX

General Provider Information

NPI Number	:	1669921862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVIN MORENO

Provider Business Mailing Address
First Line	:	3406 ANGELINA ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-2558
Country	:	US
Telephone Number	:	361-249-3274
Fax Number	:	361-266-3195

Provider Business Practice Location Address
First Line	:	5337 YORKTOWN BLVD STE 4A1
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78413-5361
Country	:	US
Telephone Number	:	361-249-3274
Fax Number	:	361-266-3195

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

Provider Enumeration Date	:	09/28/2016
Last Update Date	:	07/18/2023

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Directions to “ DEVIN MORENO ” Practice Location

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