Individual
GERARDO MARTIN MORENO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
18333 EGRET BAY BLVD, SUITE 200, HOUSTON, TX 77058-3860
(281) 333-1300
(281) 333-1303
Mailing address
18333 EGRET BAY BLVD, SUITE 200, HOUSTON, TX 77058-3860
(281) 333-1300
(281) 333-1303
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA03185
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89N255
BCBS
TX
Enumeration date
06/09/2006
Last updated
07/08/2007
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