Individual provider Active NPI

Fanny E Moron, M.D.

  • Diagnostic Radiology Physician
  • Pasadena, TX
National Provider Identifier
1093759193
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
40568 Issued in TX
Practice address
4600 E Sam Houston Pkwy S
Pasadena, TX 77505-3948
Phone
(713) 481-3533
Fax
(713) 432-0221
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 40568 TX Primary

Addresses

Primary practice location

4600 E Sam Houston Pkwy S
Pasadena, TX 77505-3948

Mailing address

PO Box 3119
Houston, TX 77253-3119
Phone (713) 481-3533

Other identifiers 5

IdentifierTypeStateIssuer
8AM788OtherTXBCBS
172439505MedicaidTX
172439504MedicaidTX
172439501MedicaidTX
172439503MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050425000259 TX Practitioner - Diagnostic Radiology 6002854510 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singleton Associates PAGroup PAC ID 6305731118, 814 clinicians
Baylor College of MedicineGroup PAC ID 8224941265, 796 clinicians
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

104 7TH St
Bay City, TX 77414-4853
Phone (281) 870-4592

1502 Taub Loop
Houston, TX 77030-1608
Phone (713) 873-4900

1504 Taub Loop
Houston, TX 77030-1608
Phone (713) 873-2000

1977 Butler Blvd
Houston, TX 77030-4101

1977 Butler Boulevard
Houston, TX 77030-4101

1977 Butler Boulevard 6TH Floor
200 BCM Physicians
Houston, TX 77030-4101
Phone (713) 798-6131

2457 S Braeswood Blvd
Houston, TX 77030-4305
Phone 71379817502

2525 A Holly Hall St
Houston, TX 77054-4124
Phone (713) 526-4243

7200 Cambridge St
Houston, TX 77030-4202

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40568TXMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Diagnostic Radiology CurrentSince Jan 1, 2014 Accepting new patients
Singleton Associates PA Diagnostic Radiology CurrentSince Mar 1, 2018 Accepting new patients
Baylor College of Medicine CurrentSince Jan 1, 2014 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
Baylor College of Medicine Past Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

104 7th St
Bay City, TX 77414
Phone (979) 241-5521

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

6720 Bertner Ave
#270
Houston, TX 77030
Phone (832) 355-4092

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6720 Bertner Ave
#2270
Houston, TX 77030
Phone (832) 355-4092

6620 Main St
Ste 1275
Houston, TX 77030
Phone (713) 798-2300

1504 Taub Loop
#621
Houston, TX 77030

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

2457 S Braeswood Blvd
Houston, TX 77030
Phone (713) 520-8860

2525 Holly Hall St
#A
Houston, TX 77054
Phone (713) 526-4243

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1093759193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3119",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772533119",
            "telephone_number": "713-481-3533",
            "fax_number": "713-432-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 E SAM HOUSTON PKWY S",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053948",
            "telephone_number": "713-481-3533",
            "fax_number": "713-432-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORON",
        "first_name": "FANNY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "40568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8AM788",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172439505",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172439504",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172439501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172439503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.