Healthcare Provider Details

I. General information

NPI: 1225694847
Provider Name (Legal Business Name): MOORE NATURAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 05/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3115 S 1ST ST
AUSTIN TX
78704-8847
US

IV. Provider business mailing address

347 ANGEL FISH DR
PALACIOS TX
77465-0539
US

V. Phone/Fax

Practice location:
  • Phone: 512-655-3570
  • Fax:
Mailing address:
  • Phone: 512-655-3570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: NATALIE L.M. CLARK
Title or Position: OWNER
Credential:
Phone: 512-655-3570