Provider Demographics
NPI:1598772600
Name:GARCIA-MORALES, NELIA PATRICIA (DDS)
Entity Type:Individual
Prefix:
First Name:NELIA
Middle Name:PATRICIA
Last Name:GARCIA-MORALES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 MCPHERSON RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6191
Mailing Address - Country:US
Mailing Address - Phone:956-717-9877
Mailing Address - Fax:956-717-9881
Practice Address - Street 1:6410 MCPHERSON RD
Practice Address - Street 2:SUITE 2
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6191
Practice Address - Country:US
Practice Address - Phone:956-717-9877
Practice Address - Fax:956-717-9881
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207181223G0001X, 1223S0112X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160749101Medicaid