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General NPI Number Information
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NPI Number | 1144672817
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Entity Type | Individual
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Provider Name | KIRA MOSS
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Gender | Female
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 18652 MCKAY BLVD STE. 100
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City | HUMBLE
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State | TX
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Zip | 77338
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Country | US
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Telephone | 281-446-1014
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Fax | 281-446-0838
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Provider Business Mailing Address
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Address Line | 17903 W LAKE HOUSTON PKWY STE 201
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City | HUMBLE
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State | TX
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Zip | 77346-3954
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Country | US
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Telephone | 281-446-7173
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Fax | 281-446-3841
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | TX
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