Provider Demographics
NPI:1265323877
Name:MORENO, ANDREA A
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:A
Last Name:MORENO
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 1:1101 ESPERANZA AVE APT J3
Mailing Address - Street 2:
Mailing Address - City:HIDALGO
Mailing Address - State:TX
Mailing Address - Zip Code:78557-4205
Mailing Address - Country:US
Mailing Address - Phone:956-313-6773
Mailing Address - Fax:
Practice Address - Street 1:1209 S 10TH ST STE 386
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5059
Practice Address - Country:US
Practice Address - Phone:956-313-6773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician