Provider Demographics
NPI:1033954177
Name:MONTES MORENO HEALTHCARE ASSOCIATES, PLLC
Entity type:Organization
Organization Name:MONTES MORENO HEALTHCARE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTES DE OCA MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:210-654-9700
Mailing Address - Street 1:5245 WALZEM RD
Mailing Address - Street 2:
Mailing Address - City:WINDCREST
Mailing Address - State:TX
Mailing Address - Zip Code:78218-2122
Mailing Address - Country:US
Mailing Address - Phone:210-654-9700
Mailing Address - Fax:210-660-1414
Practice Address - Street 1:5245 WALZEM RD
Practice Address - Street 2:
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78218-2122
Practice Address - Country:US
Practice Address - Phone:210-654-9700
Practice Address - Fax:210-660-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-29
Last Update Date:2024-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care