Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | J54178 | TX |
NPI | 1134170657 |
---|---|
Provider Name | Dr. J Mark Morales |
First Address | Corpus Christi, TX 78463-0104 |
Second Address | Corpus Christi, TX 78404-2354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 31/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
141578801 | (05) | TX |
E72772 | (02) | TX |