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General NPI Number Information
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NPI Number | 1326093410
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Entity Type | Individual
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Provider Name | SHAWN P MOORE MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 2000 S MAYS ST STE 201
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City | ROUND ROCK
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State | TX
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Zip | 78664-7580
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Country | US
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Telephone | 512-244-4272
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Fax | 512-244-2895
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Provider Business Mailing Address
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Address Line | 10740 PALM RIVER RD STE 300
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City | TAMPA
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State | FL
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Zip | 33619-4577
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Country | US
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Telephone | 813-651-3300
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Fax | 813-651-4455
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 24838
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 37505
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 04-32207
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | ME141772
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | R6846
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License Number State | TX
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