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General NPI Number Information
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NPI Number | 1932845880
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Entity Type | Individual
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Provider Name | BRANDON MOORE PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 05/12/2022
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 5000 LONG PRAIRIE RD STE 200
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2783
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Country | US
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Telephone | 214-222-6699
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Fax | 214-222-6691
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Provider Business Mailing Address
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Address Line | 410 POST OAK DR
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-6824
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Country | US
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Telephone | 214-998-3888
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1360204
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License Number State | TX
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