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General NPI Number Information
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NPI Number | 1639428980
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Entity Type | Organization
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Legal Business Name | MOORE MENTAL HEALTH & BEHAVIORAL SERVICES PLLC
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Dates
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Enumeration Date | 09/02/2012
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 17030 NANES DR STE 201
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City | HOUSTON
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State | TX
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Zip | 77090-2504
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Country | US
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Telephone | 281-415-1280
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Fax | 281-271-8927
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Provider Business Mailing Address
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Address Line | PO BOX 90446
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City | HOUSTON
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State | TX
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Zip | 77290-0446
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Country | US
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Telephone | 281-919-1059
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Fax | 281-271-8927
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELISSA A MOORE
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Credential | PSYD
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Telephone | 281-705-5620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 36006
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License Number State | TX
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