Provider Demographics
NPI:1902925001
Name:FREDDIE M MORALES MD PULMONARY DISEASES & INTERNAL MEDICINE CLINIC
Entity Type:Organization
Organization Name:FREDDIE M MORALES MD PULMONARY DISEASES & INTERNAL MEDICINE CLINIC
Other - Org Name:FREDDIE M. MORALES M.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDDIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-554-3003
Mailing Address - Street 1:2207 CLEAR CREEK RD STE 302
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4345
Mailing Address - Country:US
Mailing Address - Phone:254-554-3003
Mailing Address - Fax:254-554-8362
Practice Address - Street 1:2207 CLEAR CREEK RD STE 302
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4345
Practice Address - Country:US
Practice Address - Phone:254-554-3003
Practice Address - Fax:254-554-8362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG6081OtherSTATE LICENSE
TX174691901Medicaid
TX90055463OtherDPS REGISTRATION #
TXDB7452OtherRAILROAD GROUP NUMBER
TX0014GNOtherBLUE CROSS GROUP NUMBER
TX174691901Medicaid
TX=========OtherEIN
TXC1919571Medicare UPIN
TX90055463OtherDPS REGISTRATION #