Healthcare Provider Details

I. General information

NPI: 1568416188
Provider Name (Legal Business Name): KARAN RUTH MOSELEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 N WALDROP DR SUITE 402
ARLINGTON TX
76012-4705
US

IV. Provider business mailing address

4101 FLOWER GARDEN DR
ARLINGTON TX
76016-3920
US

V. Phone/Fax

Practice location:
  • Phone: 817-461-1702
  • Fax: 817-461-1772
Mailing address:
  • Phone: 817-461-1702
  • Fax: 817-461-1772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG3626
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG3626
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: