Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | L0435 | TX |
NPI | 1023265758 |
---|---|
Provider Name | Dr. John R Moran |
First Address | Houston, TX 77005-4092 |
Second Address | Houston, TX 77005-4092 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2008 |
Last Update Date | 25/08/2008 |