Individual
DR. EDUARDO P MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 S AVENUE C, CRYSTAL CITY, TX 78839-3834
(830) 374-2952
(830) 374-3784
Mailing address
210 S AVENUE C, P.O. BOX 725, CRYSTAL CITY, TX 78839-3834
(830) 374-2952
(830) 374-3784
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-3738
TX
207R00000X
Internal Medicine Physician
E-3738
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00BT71
BLUE CROSS BLUE SHEILD
TX
01
—
017498901
TEXAS HEALTH STEPS
TX
05
—
063386901
—
TX
Enumeration date
11/15/2006
Last updated
09/25/2007
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