Individual
TIMOTHY GLEN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
3317 FINLEY RD, SUITE 120, IRVING, TX 75062-8722
(817) 360-5364
Mailing address
3317 FINLEY RD, SUITE 120, IRVING, TX 75062-8722
(817) 360-5364
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/26/2015
Last updated
02/26/2015
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