Healthcare Provider Details

I. General information

NPI: 1003349747
Provider Name (Legal Business Name): MOSES MUSOKE PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36065 SANTA FE AVE
FORT HOOD TX
76544-5060
US

IV. Provider business mailing address

2700 TRIMMIER RD
KILLEEN TX
76542-6000
US

V. Phone/Fax

Practice location:
  • Phone: 254-288-8828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number0202211229
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: