Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 12039 | TX |
Y | 111NN1001X | Nutrition | 12039 | TX |
NPI | 1538435326 |
---|---|
Provider Name | Dr. Vanessa Morales |
First Address | Dallas, TX 75206-3907 |
Second Address | Dallas, TX 75206-3907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2012 |
Last Update Date | 27/03/2012 |