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Organization
ALVARO J MORENO OD PC
Active
Organization
ALVARO J MORENO OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALVARO J MORENO OD (OWNER)
(601) 549-1553
Entity
Organization
Contact information
Practice address
598 E CENTRAL AVE, PETAL, MS 39465-2957
(601) 450-3937
(601) 909-6104
Mailing address
598 E CENTRAL AVE, PETAL, MS 39465-2957
(601) 450-3937
(601) 909-6104
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
610
MS
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08637209
—
MS
Enumeration date
11/30/2006
Last updated
09/08/2020
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