Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 11471 | TX |
N | 111N00000X | Chiropractor | 30608 | CA |
N | 111N00000X | Chiropractor | 6787397-1202 | UT |
N | 111NI0013X | Independent Medical Examiner | 11471 | TX |
NPI | 1205033107 |
---|---|
Provider Name | Dr. Erik Moll |
First Address | San Antonio, TX 78270-0688 |
Second Address | San Antonio, TX 78232-3618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 16/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11471 | TEXAS BOARD OF CHIROPRACTIC EXAMINERS (01) | TX |