Basic Information
Provider Information
NPI: 1427024298
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORALEZ
FirstName: STEVEN
MiddleName: ANTHONY
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6243 IH 10 WEST
Address2: SUITE 480
City: SAN ANTONIO
State: TX
PostalCode: 782012089
CountryCode: US
TelephoneNumber: 2107314800
FaxNumber: 2107314810
Practice Location
Address1: 810 SE MILITARY DR
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782142823
CountryCode: US
TelephoneNumber: 2109214200
FaxNumber: 2109228181
Other Information
ProviderEnumerationDate: 02/23/2006
LastUpdateDate: 06/03/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XG2192TXY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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