Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | R0621 | TX |
NPI | 1033435367 |
---|---|
Provider Name | Dr. Abel Moron |
First Address | Dallas, TX 75391-1230 |
Second Address | Arlington, TX 76012-2510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2010 |
Last Update Date | 02/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
389747202 | (05) | TX |