Provider Demographics
NPI:1467678581
Name:MORALES, GILDA (DC, ANP-C)
Entity Type:Individual
Prefix:
First Name:GILDA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:DC, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 613
Mailing Address - Street 2:
Mailing Address - City:VAN HORN
Mailing Address - State:TX
Mailing Address - Zip Code:79855-0613
Mailing Address - Country:US
Mailing Address - Phone:432-284-0156
Mailing Address - Fax:888-842-0709
Practice Address - Street 1:EISENHOWER ROAD AND FM2185
Practice Address - Street 2:
Practice Address - City:VAN HORN
Practice Address - State:TX
Practice Address - Zip Code:79855-0609
Practice Address - Country:US
Practice Address - Phone:432-283-2760
Practice Address - Fax:432-283-2581
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6728111N00000X
TXAP127863363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U59747Medicare UPIN
8134M1Medicare ID - Type Unspecified