Individual
BACILIO MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C,P
Contact information
Practice address
5309 WURZBACH RD, LEON VALLEY, TX 78238-2431
(210) 465-9113
(210) 932-8015
Mailing address
5309 WURZBACH RD, LEON VALLEY, TX 78238-2431
(210) 465-9113
(210) 932-8015
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
79
TX
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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