Provider Demographics
NPI:1144363284
Name:MORAN, JOYCE MARIE
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:MARIE
Last Name:MORAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 DOUCETTE ST
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-5011
Mailing Address - Country:US
Mailing Address - Phone:806-665-4411
Mailing Address - Fax:
Practice Address - Street 1:613 DOUCETTE ST
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-5011
Practice Address - Country:US
Practice Address - Phone:806-665-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01-Q-1774311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home