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General NPI Number Information
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NPI Number | 1548290828
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Entity Type | Individual
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Provider Name | AARON MOSS ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 1106 N SHARY RD
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City | MISSION
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State | TX
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Zip | 78572-4652
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Country | US
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Telephone | 956-580-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 2107 E 25TH ST
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City | MISSION
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State | TX
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Zip | 78574-7499
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Country | US
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Telephone | 956-583-4711
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | TX
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