Individual
DR. RICHARD MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1721 W PLANO PKWY, SUITE 107, PLANO, TX 75075-8634
(972) 673-4111
(972) 578-8397
Mailing address
110 S BRADLEY ST, MCKINNEY, TX 75069-4509
(972) 673-4111
(972) 578-8397
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
24453
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022LV
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/18/2007
Last updated
07/08/2007
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