Individual
PHILLIP DANIEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1520 E DENMAN AVE STE 102, LUFKIN, TX 75901-5817
(936) 994-7010
Mailing address
1520 E DENMAN AVE STE 102, LUFKIN, TX 75901-5817
(936) 994-7010
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
OBTAINING
TX
Enumeration date
10/04/2019
Last updated
10/15/2019
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