Individual
LAURA JANE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6550 FANNIN ST, SUITE 1601, HOUSTON, TX 77030-2717
(713) 441-5141
Mailing address
6550 FANNIN ST, SUITE 1661A, HOUSTON, TX 77030-2717
(713) 441-5141
(713) 790-6470
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
M1246
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175544903
—
TX
01
—
8V8604
BLUE CROSS BLUE SHIELD
TX
01
—
P00427638
RAILROAD MEDICARE
TX
Enumeration date
07/07/2006
Last updated
11/04/2009
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