Individual
SHADE' BETHENA MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6410 FANNIN ST STE 500, HOUSTON, TX 77030-3005
(832) 325-7151
Mailing address
6410 FANNIN ST STE 732, HOUSTON, TX 77030-5202
(713) 500-5787
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
P0255
TX
Other
Enumeration date
05/23/2007
Last updated
07/20/2022
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