Organization
APPLETREE PEDIATRICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J KATHLEEN MOORE M.D. (OWNER/PHYSICIAN)
(903) 592-1890
Entity
Organization
Contact information
Practice address
1306 DOCTORS DR, TYLER, TX 75701-2262
(903) 592-1890
(903) 592-3222
Mailing address
1306 DOCTORS DR, TYLER, TX 75701-2262
(903) 592-1890
(903) 592-3222
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J0605
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407940547
IDIVIDUAL NPI
TX
Enumeration date
11/26/2007
Last updated
11/26/2007
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