Individual
CRAIG L MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
206 PINE TREE RD., LONGVIEW, TX 75604-4104
(903) 759-1145
(903) 759-1170
Mailing address
206 PINE TREE RD, LONGVIEW, TX 75604-4104
(903) 759-1145
(903) 759-1170
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
216424
TX
103T00000X
Psychologist
Primary
30640
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00FJ95
BCBS
TX
Enumeration date
11/30/2006
Last updated
07/09/2007
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