Moretta, Stacy R.

Moretta, Stacy R. is an individual health care provider with primary practice located at 6161 N State Highway 161 , Irving TX 75038. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Moretta, Stacy R. can be contacted via phone (972) 258-7499.

Contact Information

Primary practice address
6161 N State Highway 161 Irving TX 75038
Phone: (972) 258-7499
Fax: (972) 257-0897
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA06061 Texas

Profile Details

NPI number 1639309461
LBN Legal business name Moretta, Stacy R.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2009
Last updated Aug 24th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639309461 NPPES
Texas Other 467551YZNA MEDICARE NUMBER

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