Provider Demographics
NPI:1245276500
Name:MORALES, ANDRES G (DO)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:G
Last Name:MORALES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N HIGHLAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7371
Mailing Address - Country:US
Mailing Address - Phone:903-893-5141
Mailing Address - Fax:903-891-4285
Practice Address - Street 1:321 N HIGHLAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7371
Practice Address - Country:US
Practice Address - Phone:903-893-5141
Practice Address - Fax:903-891-4285
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK45072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0451700-01Medicaid
LA1414735Medicaid
TX4159575OtherBCBS
TX130020694OtherRR MEDICARE
TX86K943Medicare ID - Type UnspecifiedMEDICARE
LA1414735Medicaid