Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | J5186 | TX |
N | 207VG0400X | Gynecologist | J5186 | TX |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | J5186 | TX |
N | 207VX0000X | Obstetrician | J5186 | TX |
NPI | 1194721944 |
---|---|
Provider Name | Doreen A Moser |
First Address | Dallas, TX 75267-4209 |
Second Address | Grapevine, TX 76051-3580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 01/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0083CX | BCBS (01) | TX |
096896801 | (05) | TX |
096896804 | (05) | TX |
8CK620 | BCBS (01) | TX |
F83915 | (02) |