Individual
MR. JEFFREY DEAN MOFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051-3930
(817) 481-2121
(817) 488-4493
Mailing address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051-3930
(817) 481-2121
(817) 488-4493
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
L1398
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142195001
—
TX
01
—
8A6900
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/30/2005
Last updated
04/27/2020
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