Individual
CECILIA ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
3601 4TH ST, STOP 9903, LUBBOCK, TX 79430-9903
(806) 743-7337
(806) 743-7329
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT80334
TX
133VN1004X
Pediatric Nutrition Registered Dietitian
DT80334
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13785036
—
NM
05
—
193439001
—
TX
01
—
8H8762
BC/BS
TX
Enumeration date
06/19/2007
Last updated
01/30/2025
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