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Individual

TIM MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
23203 BULVERDE RD, SAN ANTONIO, TX 78259-2203
(210) 356-0583
Mailing address
16714 STONEY GLADE, SAN ANTONIO, TX 78247-2057

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT1587
TX

Other

Enumeration date
02/09/2018
Last updated
02/09/2018
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