Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 117496 | TX |
NPI | 1023470523 |
---|---|
Provider Name | Phebe A Moralez |
First Address | Houston, TX 77076-1324 |
Second Address | Houston, TX 77076-1324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2016 |
Last Update Date | 23/03/2016 |