Individual
PEDRO MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 S 2ND ST, EUNICE, LA 70535-4608
(337) 468-4038
Mailing address
803 POINCIANA AVE, MAMOU, LA 70554-2201
(337) 468-4038
(337) 468-4042
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04223R
LA
207Q00000X
Family Medicine Physician
Primary
MD.04223R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1183644
—
LA
01
—
55056
MEDICARE
LA
Enumeration date
06/02/2006
Last updated
07/16/2013
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