Individual
KELLY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
19623 HIGHWAY 59 N, HUMBLE, TX 77338-3500
(281) 973-0296
Mailing address
19623 HIGHWAY 59 N, HUMBLE, TX 77338-3500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8926T
TX
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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