Individual
JOE MARSHALL MOODY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4647 MEDICAL DR, SAN ANTONIO, TX 78229-4403
(210) 592-0400
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 617-5100
(210) 617-5179
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E2746
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124455001
—
TX
01
—
124455005
CIDC
TX
Enumeration date
08/12/2006
Last updated
05/06/2009
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