Individual
CHARLES HENRY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2206 E VILLA MARIA RD, BRYAN, TX 77802-2547
(979) 776-4600
(979) 776-8749
Mailing address
2206 E VILLA MARIA RD, BRYAN, TX 77802-2547
(979) 776-4600
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
E-4612
AR
207RG0100X
Gastroenterology Physician
Primary
M4372
TX
Other
Enumeration date
05/16/2006
Last updated
07/22/2020
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