Individual
RICHARD BRADLEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1815 S 31ST ST, TEMPLE, TX 76504
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
Q0124
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336079405
—
TX
01
—
8EW471
BLUE CROSS BLUE SHIELD
TX
01
—
P01547909
PALMETTO GBA
TX
Enumeration date
04/06/2010
Last updated
01/25/2022
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