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General NPI Number Information
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NPI Number | 1437951019
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Entity Type | Individual
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Provider Name | TRACEY EVETTE MOORE
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Gender | Female
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 2600 S LOOP W STE 285
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City | HOUSTON
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State | TX
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Zip | 77054-2780
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Country | US
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Telephone | 832-831-5884
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Fax | 346-319-4564
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Provider Business Mailing Address
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Address Line | 2600 S LOOP W STE 285
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City | HOUSTON
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State | TX
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Zip | 77054-2780
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Country | US
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Telephone | 832-831-5884
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Fax | 346-319-4564
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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Taxonomy #4
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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Taxonomy #6
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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Taxonomy #7
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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Taxonomy #8
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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Taxonomy #9
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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Taxonomy #10
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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Taxonomy #11
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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Taxonomy #12
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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Taxonomy #13
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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Taxonomy #14
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 64457
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License Number State | TX
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