Individual
ANASTASIA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 E HEBRON PKWY APT 6301, CARROLLTON, TX 75010-2126
(972) 795-8833
Mailing address
PO BOX 116763, CARROLLTON, TX 75011-6763
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312972
TX
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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