Individual
HALIE ANNETTE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPAS, MPH
Contact information
Practice address
100 W SOUTHLAKE BLVD STE 420, SOUTHLAKE, TX 76092-6166
(870) 918-2463
Mailing address
301 SILVERON APT 8102, FLOWER MOUND, TX 75028-4140
(870) 918-2463
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA16473
TX
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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