Individual
GRADIE ELIZABETH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1601 9TH ST, WICHITA FALLS, TX 76301-4304
(940) 723-8151
Mailing address
1601 9TH ST, WICHITA FALLS, TX 76301-4304
(940) 723-8151
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
P2147
TX
Other
Enumeration date
05/07/2008
Last updated
06/15/2012
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