Individual
BEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1311 GENERAL CAVAZOS BLVD, KINGSVILLE, TX 78363-7129
(361) 595-1661
Mailing address
352 BOBBY CLARK DR, CANYON LAKE, TX 78133-2124
(210) 494-1786
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D1743
TX
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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