Provider Demographics
NPI:1215241278
Name:MORENO, ARNULFO (MS SLP)
Entity type:Individual
Prefix:MR
First Name:ARNULFO
Middle Name:
Last Name:MORENO
Suffix:
Gender:M
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18407 LAKEVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5752
Mailing Address - Country:US
Mailing Address - Phone:956-599-4518
Mailing Address - Fax:
Practice Address - Street 1:2011 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5797
Practice Address - Country:US
Practice Address - Phone:281-997-8509
Practice Address - Fax:956-973-8403
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX349802355S0801X
TX118008235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant