Provider Demographics
NPI:1437432184
Name:MORALES, CARLOS (LSA, CSA)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:MORALES
Suffix:
Gender:M
Credentials:LSA, CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 DEAUVILLE BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79706
Mailing Address - Country:US
Mailing Address - Phone:432-686-0321
Mailing Address - Fax:432-686-0664
Practice Address - Street 1:5615 DEAUVILLE BLVD
Practice Address - Street 2:STE 220
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706
Practice Address - Country:US
Practice Address - Phone:432-686-0321
Practice Address - Fax:432-686-0664
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00133246Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information