Organization
A. G. MOORE M.D, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SUZANNE MANESS (BUSINESS MANAGER)
(281) 296-8686
Entity
Organization
Contact information
Practice address
1120 MEDICAL PLAZA DR, SUITE 340, SHENANDOAH, TX 77380-3242
(281) 296-8686
(281) 292-8804
Mailing address
1120 MEDICAL PLAZA DR, SUITE 340, SHENANDOAH, TX 77380-3242
(281) 296-8686
(281) 292-8804
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E8741
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0042DW
BCBS
TX
01
—
E8741
TX STATE MEDICAL LICENSE
TX
Enumeration date
12/26/2007
Last updated
12/26/2007
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