Individual
MS. DONNA LOUISE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1950 ASPEN AVE, LUBBOCK, TX 79404-1211
(806) 766-0310
(806) 766-0397
Mailing address
PO BOX 2828, 1602 10TH STREET, LUBBOCK, TX 79408-2828
(806) 766-0310
(806) 766-0397
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1084415
NCCPA
TX
Enumeration date
12/16/2008
Last updated
12/16/2008
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