Individual
DR. PHILIP ALAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 LANCASTER DR, SUITE 103, GRAPEVINE, TX 76051-3579
(817) 488-5170
(817) 488-6270
Mailing address
1600 LANCASTER DR, SUITE 103, GRAPEVINE, TX 76051-3579
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F1835
TX
Other
Enumeration date
07/11/2006
Last updated
05/13/2015
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