Provider Demographics
NPI:1871154732
Name:MOREAU ORTHOPAEDICS PLLC
Entity type:Organization
Organization Name:MOREAU ORTHOPAEDICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YVEL
Authorized Official - Middle Name:PASCAL
Authorized Official - Last Name:MOREAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-724-5666
Mailing Address - Street 1:1710 E SAUNDERS ST STE B440
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5574
Mailing Address - Country:US
Mailing Address - Phone:956-724-5666
Mailing Address - Fax:956-724-5693
Practice Address - Street 1:1710 E SAUNDERS ST STE B440
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5574
Practice Address - Country:US
Practice Address - Phone:956-724-5666
Practice Address - Fax:956-724-5693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
464099OtherMEDICARE
TX170387804Medicaid