Provider Demographics
NPI:1912123878
Name:MORALES, MIGUEL (MD)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 ALDINE MAIL RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-5509
Mailing Address - Country:US
Mailing Address - Phone:281-219-2455
Mailing Address - Fax:281-219-3959
Practice Address - Street 1:2409 ALDINE MAIL RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-5509
Practice Address - Country:US
Practice Address - Phone:281-219-2455
Practice Address - Fax:281-219-3959
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL6532207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B8966Medicare UPIN