Individual
SIDNEY MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2425 CAPITOL ST APT 2130, HOUSTON, TX 77003-3179
(713) 380-1011
Mailing address
2425 CAPITOL ST APT 2130, HOUSTON, TX 77003-3179
(713) 380-1011
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
32062681260
TX
Other
Enumeration date
02/21/2017
Last updated
02/21/2017
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