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NPI Code Detail

MEDICARE: DR. LUZ MORENO MD

MEDICARE: DR. LUZ MORENO MD
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
1207RN0300XNephrology PhysicianK1882TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790751592
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUZ MORENO MD
Provider Business Mailing Address
First Line : 16620 N US HIGHWAY 281
Second Line : STE 300
City : SAN ANTONIO
State : TX
Zip : 78232-2679
Country : US
Telephone Number : 210-614-1231
Fax Number : 210-616-0704
Provider Business Practice Location Address
First Line : 1123 N MAIN AVE STE 120
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-4738
Country : US
Telephone Number : 210-226-2001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 01/21/2019

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Directions to “ DR. LUZ MORENO MD” Practice Location

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