Individual
BRIAN R MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 724-5437
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
MD2006-0593
NM
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
R7827
TX
208000000X
Pediatrics Physician
45069
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092246300
—
MN
Enumeration date
02/15/2006
Last updated
08/19/2022
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