Individual
DR. MICHELE KAY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
7951 SHOAL CREEK BLVD STE 230, AUSTIN, TX 78757-7567
(512) 459-5523
(512) 459-5877
Mailing address
7951 SHOAL CREEK BLVD STE 230, AUSTIN, TX 78757-7567
(512) 459-5523
(512) 459-5877
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC4982
TX
111NS0005X
Sports Physician Chiropractor
Primary
4982
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4982
STATE LICENCE
TX
01
—
603967
BLUE CROSS BLUE SHIELD
TX
01
—
742542662
IRS
TX
05
—
C06039679
—
TX
Enumeration date
07/18/2006
Last updated
05/27/2019
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