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Individual
DR. SIREESHA R MOOLA
Active
Individual
DR. SIREESHA R MOOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27808
TX
1223G0001X
General Practice Dentistry
61193
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261090724
—
TX
Enumeration date
03/29/2012
Last updated
06/06/2016
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