Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 3387 | PR |
NPI | 1093721193 |
---|---|
Provider Name | Dr. Manuel Casimiro Morales |
First Address | Killeen, TX 76543-5574 |
Second Address | Temple, TX 76504-7451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |