Provider Demographics
NPI:1407850829
Name:MORALES, ROBERT P (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
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 1:5814 HOLLYHOCK RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2001
Mailing Address - Country:US
Mailing Address - Phone:210-691-1775
Mailing Address - Fax:
Practice Address - Street 1:8811 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5415
Practice Address - Country:US
Practice Address - Phone:210-297-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4545174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXX0027046OtherDPS LICENSE
TX00BJ45OtherBCBS
TXP00184518OtherMEDICARE RAILROAD
TX130534404Medicaid
TX4295761OtherAETNA
TXE4545OtherMEDICAL LICENSE
TXE4545OtherMEDICAL LICENSE
TX8J7028Medicare PIN
TXP00184518OtherMEDICARE RAILROAD
TX4295761OtherAETNA