Individual
KEVIN EDWARD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6621 FANNIN ST, HOUSTON, TX 77030-2358
(832) 824-1000
Mailing address
12055 SABO RD APT 1217, HOUSTON, TX 77089-6291
(504) 402-2642
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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