Individual
DR. JASON NICHOLAS MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4008 GATEWAY DR, SUITE 180, COLLEYVILLE, TX 76034-7914
(817) 358-0209
(817) 358-0219
Mailing address
1318 BAYTHORNE DR, LEWISVILLE, TX 75077-7691
(214) 529-2156
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
10451
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8AP440
BLUE CROSS BLUE SHEILDS
TX
Enumeration date
11/01/2006
Last updated
03/17/2008
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