Provider Demographics
NPI:1588164438
Name:MORALES, MELISSA G
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:G
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 1:9723 COUNTY ROAD 6900
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-6302
Mailing Address - Country:US
Mailing Address - Phone:806-445-7583
Mailing Address - Fax:
Practice Address - Street 1:9723 COUNTY ROAD 6900
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-6302
Practice Address - Country:US
Practice Address - Phone:806-445-7583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671798163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse