Provider Demographics
NPI:1689495640
Name:MORENO, CAROLINA (CPE, LE)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:MORENO
Suffix:
Gender:F
Credentials:CPE, LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 N COLLINS BLVD STE 505
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2672
Mailing Address - Country:US
Mailing Address - Phone:972-637-8100
Mailing Address - Fax:
Practice Address - Street 1:2007 N COLLINS BLVD STE 505
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2672
Practice Address - Country:US
Practice Address - Phone:972-637-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist