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General NPI Number Information
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NPI Number | 1952962664
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Entity Type | Individual
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Provider Name | JAMIE L MOORE PMHNP-BC, DNP
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Gender | Male
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 11500 TEXAS HIGHWAY 121 SUITE 930
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 469-200-4093
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Fax |
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Provider Business Mailing Address
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Address Line | 10204 CEDAR BREAKS VW
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City | MCKINNEY
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State | TX
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Zip | 75072-8969
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Country | US
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Telephone | 757-675-0164
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1013372
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 788960
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License Number State | TX
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