Dr. Roger Wayne Moore
Family Doctor - Adult Medicine
1 Lockheed Blvd.
Fort Worth
, Texas 76108
Dr. Roger Wayne Moore
Family Doctor - Adult Medicine
1 Lockheed Blvd.
Fort Worth
, Texas 76108
(817) 777-1956
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Dr. Roger Wayne Moore
- 8504 Fairway Dr
- Fort Worth, TX
- Zip : 76179-3121
- Fax : (817) 777-1956
- Phone : (817) 236-8700
Second Address
- Dr. Roger Wayne Moore
- 1 Lockheed Blvd.
- Fort Worth, TX
- Zip : 76108
- Fax : (817) 777-1956
- Phone : (817) 777-6461
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | C7062 | TX |
National Provider Identifier
| NPI | 1194863001 |
|---|---|
| Provider Name | Dr. Roger Wayne Moore |
| First Address | Fort Worth, TX 76179-3121 |
| Second Address | Fort Worth, TX 76108 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/02/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| D67433 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.