| Doctor Name: | JUAN JOSE MORENO |
| NPI Number: | 1255453429 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | PA03364 |
| Business Practice Address: | 122 N Alamo Rd Alamo, TX - 785162200 |
| Business Phone Number: | 9567826611 |
| Business Fax Number: | 9567821822 |
| Mailing Address: | 1002 W Sam Houston St, Suite 4 PHARR |
| State: | TX |
| Postal Code: | 785775224 |
| Phone Number: | 9567831400 |
| Fax Number: | 9567838818 |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 10/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA03364 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |