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Individual

KRISTEN MARIE MORENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042
(713) 620-4000
(713) 458-4229
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 715-9976

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP111729
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
134776704
TX
05
165770202
TX
01
430076317
RAILROAD MEDICARE
01
82656U
TX-BLUE SHIELD
Enumeration date
01/16/2007
Last updated
05/06/2020
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