Individual
AUSTIN RANDALL MOODY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7400 MERTON MINTER ST, NEURO SECTION, MAIL STOP 111D, SAN ANTONIO, TX 78229-4404
(830) 285-4096
(830) 896-3310
Mailing address
218 QUINLAN STREET, PMB #373, KERRVILLE, TX 78028
(830) 285-4096
(830) 896-3310
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G3620
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034299003
—
TX
Enumeration date
07/04/2006
Last updated
03/07/2023
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