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General NPI Number Information
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NPI Number | 1902972177
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Entity Type | Individual
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Provider Name | DEBORAH ANN MOON O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 4012 PRESTON RD SUITE 500
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City | PLANO
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State | TX
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Zip | 75093-7368
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Country | US
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Telephone | 972-985-3638
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Fax | 972-867-7062
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Provider Business Mailing Address
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Address Line | 4012 PRESTON RD SUITE 500
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City | PLANO
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State | TX
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Zip | 75093-7368
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Country | US
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Telephone | 972-985-3638
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Fax | 972-867-7062
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 5262TG
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License Number State | TX
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