Provider Demographics
NPI:1881392371
Name:MORENO, CESAR JR (DPT)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:
Last Name:MORENO
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 532047
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78553-2047
Mailing Address - Country:US
Mailing Address - Phone:956-428-2512
Mailing Address - Fax:956-428-2242
Practice Address - Street 1:2201 N BEDELL AVE STE B
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-8021
Practice Address - Country:US
Practice Address - Phone:830-775-9118
Practice Address - Fax:830-775-9229
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX3130441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist