Provider Demographics
NPI:1851020119
Name:MORALES, GILBERTO SAMUEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:SAMUEL
Last Name:MORALES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 NODDING PINES DR APT 805
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2464
Mailing Address - Country:US
Mailing Address - Phone:210-912-6343
Mailing Address - Fax:
Practice Address - Street 1:3120 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2506
Practice Address - Country:US
Practice Address - Phone:361-551-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX386201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice