Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1186 | TX |
Y | 222Z00000X | Podiatrist | 1186 | TX |
N | 213ES0131X | Foot Surgery | 1186 | TX |
NPI | 1407816960 |
---|---|
Provider Name | Gil M. Moreu |
First Address | El Paso, TX 79995-9520 |
Second Address | El Paso, TX 79905-2707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 19/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
121566705 | (05) | TX |
U20721 | (02) | TX |