Individual
DR. RODERICK DONALD MOE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16723 HUEBNER RD, SAN ANTONIO, TX 78248-2342
(210) 733-4368
(210) 402-3417
Mailing address
903 W MARTIN ST # MS 49-2, SAN ANTONIO, TX 78207-0903
(210) 358-0572
(210) 358-5940
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
F9837
TX
207YP0228X
Pediatric Otolaryngology Physician
Primary
F9837
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095065103
—
TX
05
—
126432701
—
TX
05
—
126432706
—
TX
01
—
20082224
DPS
TX
01
—
F9837
PHYSICIAN PERMIT
TX
Enumeration date
07/06/2006
Last updated
08/27/2024
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