Provider Demographics
NPI:1407007073
Name:C.SCOTT MORELAND, D.O.,PLLC
Entity Type:Organization
Organization Name:C.SCOTT MORELAND, D.O.,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MORELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-424-2595
Mailing Address - Street 1:12946 DAIRY ASHFORD RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3161
Mailing Address - Country:US
Mailing Address - Phone:281-242-2595
Mailing Address - Fax:281-242-2909
Practice Address - Street 1:12946 DAIRY ASHFORD RD
Practice Address - Street 2:SUITE 260
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3161
Practice Address - Country:US
Practice Address - Phone:281-242-2595
Practice Address - Fax:281-242-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7459261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health