Individual
MARINA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1201 W 38TH ST, AUSTIN, TX 78705-1006
(512) 324-1058
Mailing address
1201 W 38TH ST, AUSTIN, TX 78705-1006
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
BP10078522
TX
Other
Enumeration date
03/29/2022
Last updated
10/26/2022
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