Provider Demographics
NPI:1164099750
Name:MORA, SYLVIA MARIA
Entity Type:Individual
Prefix:MISS
First Name:SYLVIA
Middle Name:MARIA
Last Name:MORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 SAN BERNARDO AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-4476
Mailing Address - Country:US
Mailing Address - Phone:956-724-3751
Mailing Address - Fax:956-724-2203
Practice Address - Street 1:1019 SAN BERNARDO AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-4476
Practice Address - Country:US
Practice Address - Phone:956-724-3751
Practice Address - Fax:956-724-2203
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50369237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist