Healthcare Provider Details

I. General information

NPI: 1174344931
Provider Name (Legal Business Name): LOUIS DAVID MOSER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24044 CINCO VILLAGE CENTER BLVD STE 100
KATY TX
77494-8433
US

IV. Provider business mailing address

14930 MUESCHKE RD STE 100
CYPRESS TX
77433-0980
US

V. Phone/Fax

Practice location:
  • Phone: 346-206-3992
  • Fax: 832-652-3626
Mailing address:
  • Phone: 346-206-3992
  • Fax: 832-652-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17897
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: