Individual
DR. COREY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-7000
Mailing address
1620 S BROADWAY AVE, TYLER, TX 75701-4260
(903) 533-0367
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
63524
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63524
—
TX
Enumeration date
06/02/2017
Last updated
03/26/2021
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