Individual
DR. MICHAEL MOAK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3851 ROGER BROOKE DR, MCHE-QD (CREDENTIALS), FORT SAM HOUSTON, TX 78234-4501
(210) 916-3290
Mailing address
3634 EAGLE CANYON DR, SAN ANTONIO, TX 78247-4460
(210) 495-0313
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
BP10024057
TX
Other
Enumeration date
11/04/2005
Last updated
07/08/2007
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