Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 28929 | TX |
NPI | 1003254814 |
---|---|
Provider Name | Dr. Tracy Renee' Morales |
First Address | Houston, TX 77008-3906 |
Second Address | Houston, TX 77008-3906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2013 |
Last Update Date | 23/12/2015 |