Provider Demographics
NPI:1841966041
Name:MORA, JOSE (DC)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:MORA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9012 RESEARCH BLVD STE C7
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-7063
Mailing Address - Country:US
Mailing Address - Phone:512-459-4014
Mailing Address - Fax:
Practice Address - Street 1:9012 RESEARCH BLVD STE C7
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-7063
Practice Address - Country:US
Practice Address - Phone:512-459-4014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor