Provider Demographics
NPI:1386369403
Name:MORALES, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 753
Mailing Address - Street 2:
Mailing Address - City:SUTHERLAND SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78161-0753
Mailing Address - Country:US
Mailing Address - Phone:830-251-9297
Mailing Address - Fax:
Practice Address - Street 1:14414 US HIGHWAY 87 W
Practice Address - Street 2:
Practice Address - City:LA VERNIA
Practice Address - State:TX
Practice Address - Zip Code:78121-5922
Practice Address - Country:US
Practice Address - Phone:830-779-3109
Practice Address - Fax:830-779-4190
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician