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Individual

KENNETH P MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
801 N BEDELL AVE, DEL RIO, TX 78840-4112
(830) 703-1733
(830) 703-1733
Mailing address
PO BOX 437, SAN ANTONIO, TX 78292-0437
(210) 558-6288
(210) 558-6289

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
P0100
TX

Other

Enumeration date
05/18/2007
Last updated
10/21/2015
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