Individual
KIMBERLY A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2701 HOSPITAL DR, VICTORIA, TX 77901
(361) 573-6291
(361) 576-2434
Mailing address
1501 E MOCKINGBIRD LN STE 101, VICTORIA, TX 77904-2178
(361) 573-6291
(361) 576-2434
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M8851
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197148301
—
TX
01
—
8P8741
TX BCBS
TX
01
—
P00808584
RR MEDICARE
TX
Enumeration date
04/04/2008
Last updated
08/28/2018
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