Individual
TANISHCIA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2935 PALADIUM DR, GRAND PRAIRIE, TX 75052-8045
(817) 805-3026
Mailing address
2112 DENIRO DR, FORT WORTH, TX 76134-4153
(817) 805-3026
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/26/2018
Last updated
08/26/2018
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