Individual
DR. GARRY SCOTT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236
(210) 292-9556
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 292-6225
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
G8296
TX
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
G8296
TX
Other
Enumeration date
11/07/2005
Last updated
06/07/2018
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