Individual
LAMAR KING MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 ELIZABETH ST, CORPUS CHRISTI, TX 78404-2235
(361) 813-4377
Mailing address
15225 ISABELLA CT, CORPUS CHRISTI, TX 78418-6921
(361) 813-4377
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
P1109
TX
390200000X
Student in an Organized Health Care Education/Training Program
532734
TX
Other
Enumeration date
05/29/2008
Last updated
06/01/2020
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