Provider Demographics
NPI:1265488332
Name:MORALES, LUIS F (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:F
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5235 SOUTHMOST RD
Mailing Address - Street 2:STE B
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-8056
Mailing Address - Country:US
Mailing Address - Phone:956-504-6227
Mailing Address - Fax:956-548-1158
Practice Address - Street 1:5235 SOUTHMOST RD
Practice Address - Street 2:STE B
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-8056
Practice Address - Country:US
Practice Address - Phone:956-504-6227
Practice Address - Fax:956-548-1158
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3800207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
8602B9Medicare ID - Type Unspecified
G67921Medicare UPIN