Individual
DR. EVERETT ALBERT MOODY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3200 N MACARTHUR BLVD, STE 200, IRVING, TX 75062-4404
(972) 258-7979
(972) 570-5502
Mailing address
3200 N MACARTHUR BLVD, STE 200, IRVING, TX 75062-4404
(972) 258-7979
(972) 570-5502
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D0977
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11369
OPTICARE ID
TX
01
—
2224973
BLUE LINK ID
TX
01
—
4821
PARKLAND MEDICAID ID
TX
01
—
74309
AMERIGROUP ID
TX
01
—
8091K0
BLUE CROSS BLUE SHEILD
TX
01
—
9001
COMMISSION FOR THE BLIND
TX
Enumeration date
06/20/2005
Last updated
06/01/2021
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