Healthcare Provider Details

I. General information

NPI: 1396752002
Provider Name (Legal Business Name): JAMES D MOERS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 LEXINGTON ST
HOUSTON TX
77098-4011
US

IV. Provider business mailing address

2115 LEXINGTON ST
HOUSTON TX
77098-4011
US

V. Phone/Fax

Practice location:
  • Phone: 713-524-8800
  • Fax: 713-522-3496
Mailing address:
  • Phone: 713-524-8800
  • Fax: 713-522-3496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11116
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: