Healthcare Provider Details

I. General information

NPI: 1467873224
Provider Name (Legal Business Name): DANIEL M. MOYA R. NCS T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2013
Last Update Date: 12/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W PARKER RD STE B
HOUSTON TX
77091-3202
US

IV. Provider business mailing address

411 W PARKER RD STE B
HOUSTON TX
77091-3202
US

V. Phone/Fax

Practice location:
  • Phone: 281-667-6568
  • Fax:
Mailing address:
  • Phone: 281-667-6568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number829
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number829
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: