ALVARO J MORENO OD PC (NPI# 1013085935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013085935 |
| Entity Type | Organization |
| Organization Name | ALVARO J MORENO OD PC |
| Practice Address |
598 E Central Ave Petal MS 39465-2957 |
| Practice Telephone | 6014503937 |
| Practice Fax Number | 6019096104 |
| Mailing Telephone | 6014503937 |
| Mailing Fax Number | 6019096104 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | DR. ALVARO J MORENO (OWNER) |
| Authorized Official Telephone | 6015491553 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 610 | MS | Eye and Vision Services Providers |
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08637209 | 05 |
| Street Address |
598 E CENTRAL AVE |
| City | PETAL |
| State | MS |
| Zip Code | 39465-2957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548347834 | Alvaro Jorge Moreno | Optometrist | 598 E Central Ave, Petal, MS 39465-2957 | 2006-11-01 |
| 1518577337 | Alvaro Paul Moreno | Optometrist | 598 E Central Ave, Petal, MS 39465-2957 | 2020-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164055489 | R&p Elite Services, LLC | Private Vehicle | 68 Springfield Rd., Petal, MS 39465 | 2020-02-14 |
| 1003460544 | Hayden White | Pharmacist | 36 Byrd Dr., Petal, MS 39465 | 2019-08-01 |
| 1134612971 | Chandler Mccarley Hawkins | Dentist | 1115 Evelyn Gandy Parkway, Petal, MS 39465 | 2018-06-06 |
| 1881199818 | Lauren O'neal Garner | Nurse Practitioner | 36 Stadium Drive, Petal, MS 39465 | 2018-03-30 |
| 1700036928 | Petal School District | Registered Nurse | 60 Herrington Road, Petal, MS 39465 | 2008-09-24 |
| 1962679043 | Hattiesburg Eye Clinic Pa | Optometrist | 1223 Hwy 42, Ste 140, Petal, MS 39465 | 2008-05-08 |
| 1023228640 | Noal Baxter Cochran | Marriage & Family Therapist | 80 Lakeland Circle, Petal, MS 39465 | 2007-05-23 |
| 1750596938 | James A Nicholson Dds Pa | Dentist | 120 South 28th Avenue, Hattiesburg, MS 39465 | 2007-05-11 |
| 1356563605 | Petal School District | Registered Nurse | 400 Hillcrest Loop, Petal, MS 39465 | 2007-05-03 |
| 1154480804 | Mary E Thomsen | Orthotic Fitter | 173 Cherry Oak Trail, Petal, MS 39465 | 2006-12-08 |
| Find all providers in zip 39465 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.