Bacilio Moreno, C,P

NPI #1205281169 in Leon Valley, Texas

Provider Information

NPI Number: 1205281169
Entity Type: Individual
Name: Bacilio Moreno, C,P
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Prosthetist
Credential: C,P
Enumeration Date: Apr 28, 2016
Last Updated: Apr 28, 2016

Practice Location

Address: 5309 WURZBACH RD
City: Leon Valley
State: Texas
ZIP Code: 78238-2431
Phone: (210) 465-9113

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Prosthetist	224P00000X	Primary

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