Provider Demographics
NPI:1558330761
Name:MOREAU, YVEL P (MD)
Entity Type:Individual
Prefix:
First Name:YVEL
Middle Name:P
Last Name:MOREAU
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 1:1710 E SAUNDERS ST STE B440
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5574
Mailing Address - Country:US
Mailing Address - Phone:956-724-5666
Mailing Address - Fax:956-724-5693
Practice Address - Street 1:1710 E SAUNDERS ST STE B440
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5574
Practice Address - Country:US
Practice Address - Phone:956-724-5666
Practice Address - Fax:956-724-5693
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9818207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170387804Medicaid
TX464099OtherMEDICARE PTAN