Provider Demographics
NPI:1083946719
Name:DANIEL, NELDA MORALES (LVN)
Entity Type:Individual
Prefix:
First Name:NELDA
Middle Name:MORALES
Last Name:DANIEL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1846 W MULBERRY
Mailing Address - Street 2:1846 W MULBERRY
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-4928
Mailing Address - Country:US
Mailing Address - Phone:210-222-0152
Mailing Address - Fax:210-222-1392
Practice Address - Street 1:2391 NE LOOP 410
Practice Address - Street 2:2391 NE LOOP 410
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5600
Practice Address - Country:US
Practice Address - Phone:210-222-0152
Practice Address - Fax:210-222-1392
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80655164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80655OtherLVN