# JENNIFER M MOSS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Concho Valley OB-GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164819603
- **Authorized official:** JENNIFER MICHELE MOSS M.D. (SOLE PROPRIETOR)
- **Authorized official phone:** (325) 944-9999

## Contact information

- **Practice address:** 3019 GREEN MEADOW DR, SAN ANGELO, TX 76904-6975
- **Practice address phone:** (325) 944-9999
- **Practice address fax:** (325) 944-9996
- **Mailing address:** 3019 GREEN MEADOW DR, SAN ANGELO, TX 76904-6975
- **Mailing address phone:** (325) 944-9999
- **Mailing address fax:** (325) 944-9996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | K7835 | TX | Yes |

## Other

- **Enumeration date:** 04/22/2015
- **Last updated:** 09/29/2015