Individual
DR. JAMES T MOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3501 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7610
(817) 573-1153
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D6112
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139053626
—
TX
01
—
MO8V0607
BLUE SHIELD
TX
Enumeration date
07/12/2006
Last updated
08/18/2009
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