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General NPI Number Information
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NPI Number | 1962697565
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Entity Type | Organization
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Legal Business Name | DAVID MOORE, O.D., P.C.
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 261 N HARBIN DR
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City | STEPHENVILLE
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State | TX
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Zip | 76401-2814
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Country | US
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Telephone | 254-968-2345
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Fax | 254-968-2352
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Provider Business Mailing Address
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Address Line | 261 N HARBIN DR
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City | STEPHENVILLE
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State | TX
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Zip | 76401-2814
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Country | US
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Telephone | 254-968-2345
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Fax | 254-968-2352
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. DAVID A MOORE
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Credential | O.D.
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Telephone | 254-968-2345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7091T
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License Number State | TX
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