Individual
EDDIE P MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 PINE ST, ABILENE, TX 79601-2432
(325) 670-2151
Mailing address
PO BOX 5210, NORMAN, OK 73070-5210
(866) 321-8433
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E4540
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
E4540
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139147616
—
TX
05
—
139147617
—
TX
01
—
P01132174
MEDICARE RAILROAD
TX
Enumeration date
10/13/2005
Last updated
03/19/2013
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