=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962227637
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MISS ASHLEY N MOORE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2024
-----------------------------------------------------
Last Update Date | 11/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12333 SOWDEN RD STE B5602125
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77080-2058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-219-3743
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12333 SOWDEN RD STE B5602125
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77080-2058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-219-3743
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2278H0200X
-----------------------------------------------------
Taxonomy Name | Home Health Certified Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------