Individual
KENNETH JOSEPH MOISE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4910 MUELLER BLVD, SUITE 103, AUSTIN, TX 78723
(512) 324-7256
Mailing address
4910 MUELLER BLVD, SUITE 103, AUSTIN, TX 78723
(512) 324-7256
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
G9624
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133880817
—
TX
Enumeration date
08/03/2006
Last updated
05/20/2021
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