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NPI Code Detail

MEDICARE: DR. MATTHEW JOSEPH MOODY PHARM.D.

MEDICARE:  DR. MATTHEW JOSEPH MOODY  PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist41887TX

General Provider Information

NPI Number : 1457680175
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW JOSEPH MOODY PHARM.D.
Provider Business Mailing Address
First Line : 799 LOUIS HENNA BLVD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-7074
Country : US
Telephone Number : 512-310-7678
Fax Number : 512-310-7651
Provider Business Practice Location Address
First Line : 799 LOUIS HENNA BLVD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-7074
Country : US
Telephone Number : 512-310-7678
Fax Number : 512-310-7651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2009
Last Update Date : 12/08/2009

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Directions to “ DR. MATTHEW JOSEPH MOODY PHARM.D.” Practice Location

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