Provider Demographics
NPI:1053530931
Name:MORALES, ADOLFO PABLO (MD)
Entity type:Individual
Prefix:DR
First Name:ADOLFO
Middle Name:PABLO
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1506 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2425
Mailing Address - Country:US
Mailing Address - Phone:956-583-0202
Mailing Address - Fax:956-583-0200
Practice Address - Street 1:1506 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2425
Practice Address - Country:US
Practice Address - Phone:956-583-0202
Practice Address - Fax:956-583-0200
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18876207W00000X
TXN5884207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX212393702Medicaid
AZ287195Medicaid
AZE23929Medicare UPIN
AZ287195Medicaid
TX212393702Medicaid