MEDICARE: J MORAN & ASSOCIATES FOOT & ANKLE CLINIC PA

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	261Q00000X	Clinic/Center	1520	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1891978326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J MORAN & ASSOCIATES FOOT & ANKLE CLINIC PA

Provider Business Mailing Address
First Line	:	13406 MEDICAL COMPLEX DR STE 140
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375-3330
Country	:	US
Telephone Number	:	281-290-0400
Fax Number	:

Provider Business Practice Location Address
First Line	:	13406 MEDICAL COMPLEX DR
Second Line	:	STE 140
City	:	TOMBALL
State	:	TX
Zip	:	77375-3330
Country	:	US
Telephone Number	:	281-290-0400
Fax Number	:

Authorized Official
Title or Position	:	PODIATRIC SURGEON
Name	:	MR. JEREMY SCOTT MORAN
Credential	:	DPM
Telephone Number	:	281-290-0400

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	03/20/2009

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