Eduardo P Moreno, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-3738 Issued in TX

Practice address

210 S Avenue C
Crystal City, TX 78839-3834

Phone

(830) 374-2952

Fax

(830) 374-3784

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Eduardo Moreno, M.D., Rural Health Clinic, LLP

  • Rural Health Clinic/Center
  • Crystal City, TX
  • NPI 1376732099

  Corporate Director, General Partnership Interest

  CMS ownership

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1629140306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S AVENUE C",
            "address_2": "P.O. BOX 725",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788393834",
            "telephone_number": "830-374-2952",
            "fax_number": "830-374-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S AVENUE C",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788393834",
            "telephone_number": "830-374-2952",
            "fax_number": "830-374-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "EDUARDO",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "E-3738",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E-3738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063386901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS HEALTH STEPS",
            "identifier": "017498901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "00BT71",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• M.D.S. Interests, LLC.
• Maa Crystal Dental
• Keyna Mata
• Adrianna Mendoza
• Vickie Vel Mendoza
• Ashley Moron
• Gloria L Ortiz, LPC
• Lorenzo Ortiz, LPC
• Karen Louise Richardson, PT
• Antonio H. Rivera, M.D.

• Family Medicine Physician in Crystal City, TX
• Providers in Crystal City, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.