Provider Demographics
NPI:1790729481
Name:CYNTHIA H. MORAN, PA
Entity Type:Organization
Organization Name:CYNTHIA H. MORAN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-759-7814
Mailing Address - Street 1:11222 RICHMOND AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082
Mailing Address - Country:US
Mailing Address - Phone:281-759-7814
Mailing Address - Fax:281-759-7827
Practice Address - Street 1:11222 RICHMOND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6662
Practice Address - Country:US
Practice Address - Phone:281-759-7814
Practice Address - Fax:281-759-7827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3251310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000072G6Medicaid
TX00072GMedicare ID - Type Unspecified
TXE03348Medicare UPIN
TX00614VMedicare ID - Type Unspecified
TXP000072G6Medicaid