Provider Demographics
NPI:1114590494
Name:MORA, UBALDO (DPT)
Entity Type:Individual
Prefix:DR
First Name:UBALDO
Middle Name:
Last Name:MORA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 587
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:TX
Mailing Address - Zip Code:76856-0587
Mailing Address - Country:US
Mailing Address - Phone:325-347-4300
Mailing Address - Fax:
Practice Address - Street 1:310 FORT MCKAVITT ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:TX
Practice Address - Zip Code:76856-7685
Practice Address - Country:US
Practice Address - Phone:325-294-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist