Healthcare Provider Details

I. General information

NPI: 1134042005
Provider Name (Legal Business Name): CADEN ANDREW MOORE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 STATE HIGHWAY 71
MARBLE FALLS TX
78654
US

IV. Provider business mailing address

10904 LAKE WHITNEY DR
TEMPLE TX
76502-6474
US

V. Phone/Fax

Practice location:
  • Phone: 830-210-8000
  • Fax:
Mailing address:
  • Phone: 254-931-4631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: