Individual
JUAN G MORONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1255 W 15TH ST, PLANO, TX 75075-7299
(972) 673-0404
Mailing address
5954 E MAIN ST, NACOGDOCHES, TX 75961-1730
(903) 780-0420
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
320225
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
320225
LVN
TX
Enumeration date
08/07/2018
Last updated
08/07/2018
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