Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | Q7583 | TX |
Y | 2081P2900X | Pain Medicine | Q7583 | TX |
NPI | 1073879607 |
---|---|
Provider Name | Erika Lee Moody |
First Address | Houston, TX 77030-2717 |
Second Address | Houston, TX 77030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2012 |
Last Update Date | 01/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
394016501 | (05) | TX |