Healthcare Provider Details

I. General information

NPI: 1760639934
Provider Name (Legal Business Name): BUFFORD D MOORE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 03/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 GARTH RD STE 301
BAYTOWN TX
77521-3900
US

IV. Provider business mailing address

2802 GARTH RD STE 301
BAYTOWN TX
77521-3900
US

V. Phone/Fax

Practice location:
  • Phone: 281-422-5000
  • Fax: 281-422-5005
Mailing address:
  • Phone: 281-422-5000
  • Fax: 281-422-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BUFFORD D MOORE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 281-422-5000