Individual
DIANA E MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 RIDGEMAR DR, CLEBURNE, TX 76031-1353
(817) 556-6000
Mailing address
532 NW TARRANT AVE, BURLESON, TX 76028-3836
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1015902
TX
Other
Enumeration date
10/04/2020
Last updated
10/04/2020
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