Individual
DR. RONALD CLIFFORD MOOMAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6839 COMMUNICATIONS PKWY, PLANO, TX 75024-5991
(972) 733-7242
Mailing address
15 LAKEWOOD LN, SEABROOK, TX 77586-3432
(614) 205-0985
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
N6503
TX
2084P0800X
Psychiatry Physician
34-03169
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06253415
—
OH
01
—
34003169
LICENSE NUMBER OHIO
OH
01
—
N6503
TEXAS LICENSE
TX
01
—
V0174052
DPS TEXAS
TX
Enumeration date
04/06/2007
Last updated
10/02/2023
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