Individual
TERRA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16400 BLANCO RD, SAN ANTONIO, TX 78232-1902
(210) 572-4954
Mailing address
12522 N POINTE RD, WINONA, TX 75792-6234
(903) 570-0423
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
217528
TX
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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