Individual
NATHAN RAYMOND MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
930 NORTH CENTRAL EXPRESSWAY, STE 100, DALLAS, TX 75231
(214) 265-2810
Mailing address
5601 CEDAR RIDGE DR, MIDLOTHIAN, TX 76065-4603
(205) 965-3923
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R6845
TX
390200000X
Student in an Organized Health Care Education/Training Program
58.003731
OH
Other
Enumeration date
01/06/2011
Last updated
07/06/2022
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