Healthcare Provider Details

I. General information

NPI: 1891731063
Provider Name (Legal Business Name): ROBERT JAMES MOORE III DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 FM 2920 RD STE N
SPRING TX
77388-3590
US

IV. Provider business mailing address

2616 FM 2920 RD STE N
SPRING TX
77388-3590
US

V. Phone/Fax

Practice location:
  • Phone: 713-385-0077
  • Fax: 832-375-1247
Mailing address:
  • Phone: 281-444-6300
  • Fax: 832-375-1247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1185
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1185
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: