Healthcare Provider Details

I. General information

NPI: 1386894921
Provider Name (Legal Business Name): RICK P MOSES LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4430 E 14TH ST UNIT E-3
BROWNSVILLE TX
78521-3363
US

IV. Provider business mailing address

32092 FM 803
LOS FRESNOS TX
78566-4211
US

V. Phone/Fax

Practice location:
  • Phone: 956-434-1351
  • Fax: 866-844-2096
Mailing address:
  • Phone: 956-434-1351
  • Fax: 866-844-2096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4663
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: