Individual
JOHNNY CLIFTON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
860 HEBRON PKWY STE 1101, LEWISVILLE, TX 75057-5147
(469) 444-2244
Mailing address
4705 CLEVES AVE, AUBREY, TX 76227-1881
(693) 200-0007
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1184125
TX
Other
Enumeration date
01/02/2025
Last updated
01/02/2025
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