Provider Demographics
NPI:1790993210
Name:MORSE, LADELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:LADELLE
Middle Name:
Last Name:MORSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25723 OLD FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-5452
Mailing Address - Country:US
Mailing Address - Phone:210-450-6810
Mailing Address - Fax:210-450-6023
Practice Address - Street 1:25723 OLD FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78015
Practice Address - Country:US
Practice Address - Phone:210-450-6810
Practice Address - Fax:210-450-6023
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0294208100000X
TXBP10022459390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ431598Medicaid
TX389695301Medicaid
TX389695302OtherCSHCN