Organization
PHILIP A. MOORE, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP ALAN MOORE M.D. (OWNER)
(817) 488-5170
Entity
Organization
Contact information
Practice address
1600 W COLLEGE ST, SUITE LL20, GRAPEVINE, TX 76051-3580
(817) 488-5170
(817) 488-6270
Mailing address
1600 W COLLEGE ST, SUITE LL20, GRAPEVINE, TX 76051-3580
(817) 488-5170
(817) 488-6270
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F1835
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0362543
—
TX
Enumeration date
03/30/2011
Last updated
03/30/2011
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