Individual
DR. EVERETT ALBERT MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
07/13/2026
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