Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | G1119 | TX |
NPI | 1174525034 |
---|---|
Provider Name | Dr. Warren Moore |
First Address | Houston, TX 77030-2604 |
Second Address | Houston, TX 77030-2604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 02/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C19513 | (02) | TX |