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General NPI Number Information
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NPI Number | 1467716324
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Entity Type | Organization
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Legal Business Name | ANDREW W MOORE DC PC
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 8507 MCCULLOUGH AVE SUITE A-1
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6458
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Country | US
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Telephone | 210-525-9063
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Fax | 210-308-0494
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Provider Business Mailing Address
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Address Line | 8507 MCCULLOUGH AVE SUITE A-1
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6458
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Country | US
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Telephone | 210-525-9063
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Fax | 210-308-0494
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Authorized Official
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Title or Position | DC/OWNER
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Name | DR. ANDREW W MOORE
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Credential | DC
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Telephone | 210-525-9063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4749
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License Number State | TX
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