Provider Demographics
NPI:1235169640
Name:MORALES, FREDDIE MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDDIE
Middle Name:MIGUEL
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2207 S CLEAR CREEK RD
Mailing Address - Street 2:STE 302
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4345
Mailing Address - Country:US
Mailing Address - Phone:254-554-3003
Mailing Address - Fax:254-554-8362
Practice Address - Street 1:2207 S CLEAR CREEK RD
Practice Address - Street 2:STE 302
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4345
Practice Address - Country:US
Practice Address - Phone:254-554-3003
Practice Address - Fax:254-554-8362
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6081207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119828103OtherFIRST CARE PROVIDER # PUL
TX90055463OtherDPS REGISTRATION #
TX90040OtherSCOTT & WHITE PROVIDER ID
TX133137309Medicaid
TXDB7452OtherRAILROAD GROUP NUMBER
TX119828102OtherFIRSTCARE PROVIDER NUMBER
TX841618018OtherFEDERAL TAX ID
TXG6081OtherSTATE LICENSE
TX174691901Medicaid
TX8B0441OtherBCBS PROVIDER NUMBER
TXP00125405OtherRAILROAD PROVIDER NUMBER
TX0014GNOtherBCBS GROUP NUMBER
TXG6081OtherSTATE LICENSE