Provider Demographics
NPI:1588122774
Name:MORAN, JASON JAMES (RN)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:JAMES
Last Name:MORAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38706 SUGAR WOOD DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-2621
Mailing Address - Country:US
Mailing Address - Phone:713-331-5461
Mailing Address - Fax:
Practice Address - Street 1:38706 SUGAR WOOD DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-2621
Practice Address - Country:US
Practice Address - Phone:713-331-5461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9293362083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty