Provider Demographics
NPI:1043305055
Name:MORALES, SYLVIA REBECA (OD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:REBECA
Last Name:MORALES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10728 EASTEX FRWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77093-3600
Mailing Address - Country:US
Mailing Address - Phone:713-697-7875
Mailing Address - Fax:713-694-6716
Practice Address - Street 1:10728 EASTEX FRWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-3600
Practice Address - Country:US
Practice Address - Phone:713-697-7875
Practice Address - Fax:713-694-6716
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6451TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5981180001OtherCIGNA GOVERNMENT SERVICES
TX179078401Medicaid
TXV00458Medicare UPIN
TX179078401Medicaid