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NPI Code Detail

MEDICARE: DENISE ELAINE ERTEL-MOORE MSN, APRN, NP-BC

MEDICARE: DENISE ELAINE ERTEL-MOORE MSN, APRN, NP-BC
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
1363LG0600XGerontology Nurse Practitioner616776TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NP7255OTHERTXBCBSTX
2827N81OTHERTXBC/BS W/TRUMEN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639129364
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE ELAINE ERTEL-MOORE MSN, APRN, NP-BC
Provider Business Mailing Address
First Line : 40 CYPRESS CREEK PKWY
Second Line : SUITE 334
City : HOUSTON
State : TX
Zip : 77090-3530
Country : US
Telephone Number : 281-802-6054
Fax Number : 281-817-5863
Provider Business Practice Location Address
First Line : 7887 CAMBRIDGE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77054-2013
Country : US
Telephone Number : 281-802-6054
Fax Number : 281-817-5863
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 08/31/2014

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