Individual
DR. PETER MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12920 DAIRY ASHFORD RD STE 105, SUGAR LAND, TX 77478-3178
(832) 372-6844
Mailing address
12920 DAIRY ASHFORD RD STE 105, SUGAR LAND, TX 77478-3178
(832) 372-6844
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3-0929
TX
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
3-0929
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144475401
—
TX
01
—
51ES
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/11/2007
Last updated
04/24/2025
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