Individual
DANETTE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 SW 11TH PL, ANDREWS, TX 79714-7511
(432) 352-2822
Mailing address
611 SW 11TH PL, ANDREWS, TX 79714-7511
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
200027
TX
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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