Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | G5409 | TX |
NPI | 1093745390 |
---|---|
Provider Name | James Bruce Moseley |
First Address | Houston, TX 77070-4347 |
Second Address | Houston, TX 77070-4347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 21/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093745390 | BLUE CROSS BLUE SHIELD (01) | TX |
610197300 | US DEPT OF LABOR (01) | TX |
8K662 | BLUE CROSS BLUE SHIELD (01) | TX |
8L3455 | MEDICARE NUMBER-RBJC (01) | TX |
P00288480 | MEDICARE RR (01) | TX |