MEDICARE: ROBERT MORALES, M.D.,P.A.

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	207Q00000X	Family Medicine Physician	M4375	TX

General Provider Information

NPI Number	:	1780866269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT MORALES, M.D.,P.A.

Provider Business Mailing Address
First Line	:	1022B SOUTH 14TH STREET
Second Line	:
City	:	KINGSVILLE
State	:	TX
Zip	:	78363
Country	:	US
Telephone Number	:	361-595-1986
Fax Number	:	361-595-1478

Provider Business Practice Location Address
First Line	:	1022B S 14TH ST
Second Line	:
City	:	KINGSVILLE
State	:	TX
Zip	:	78363-6422
Country	:	US
Telephone Number	:	361-595-1986
Fax Number	:	361-595-1478

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	ROBERT MORALES
Credential	:	M.D
Telephone Number	:	361-595-1986

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	11/27/2007

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