Provider Demographics
NPI:1851647689
Name:THE MORALES GROUP LLC
Entity Type:Organization
Organization Name:THE MORALES GROUP LLC
Other - Org Name:RAYCON MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REINALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-338-0530
Mailing Address - Street 1:314 E NAKOMA ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2729
Mailing Address - Country:US
Mailing Address - Phone:210-338-0530
Mailing Address - Fax:
Practice Address - Street 1:314 E NAKOMA ST STE A
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2729
Practice Address - Country:US
Practice Address - Phone:210-338-0530
Practice Address - Fax:210-338-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4597261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center