Individual
DR. DANIEL J MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1105 CENTRAL EXPY N, SUITE 250, ALLEN, TX 75013-6103
(972) 747-5437
(972) 747-5497
Mailing address
1105 CENTRAL EXPY N, SUITE 250, ALLEN, TX 75013-6103
(972) 747-5437
(972) 747-5497
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L1138
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202347093
IRS GROUP TAX ID
TX
Enumeration date
05/12/2006
Last updated
09/10/2009
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