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General NPI Number Information
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NPI Number | 1972580132
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Entity Type | Individual
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Provider Name | LEN MOORE OUZTS MD
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Gender | Male
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 06/09/2015
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Provider Practice Location Address
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Address Line | 10298 COTTONWOOD RD
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City | VERNON
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State | TX
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Zip | 76384-5714
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Country | US
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Telephone | 940-552-7221
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Fax | 940-552-2509
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Provider Business Mailing Address
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Address Line | PO BOX 1869
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City | VERNON
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State | TX
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Zip | 76385-1869
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Country | US
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Telephone | 940-552-7221
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01059906A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | H2041
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License Number State | TX
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