Provider Demographics
NPI:1134382534
Name:MORALES, KRISTY (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:
Last Name:MORALES
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:PO BOX 3045
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-0745
Mailing Address - Country:US
Mailing Address - Phone:956-682-6146
Mailing Address - Fax:956-631-0441
Practice Address - Street 1:4302 S SUGAR RD STE 206
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9140
Practice Address - Country:US
Practice Address - Phone:956-682-6146
Practice Address - Fax:956-631-0441
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008016199207V00000X
TXR3715207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO701000339Medicare UPIN