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Physician Compare National (NPI:1679749741)

HEALTHCARE PROVIDER: GRADIE ELIZABETH MOORE M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1679749741
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5890950984
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20120621000661
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MOORE
Individual professional last name
Provider First Name GRADIE
Individual professional first name
Provider Middle Name E
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2012
Individual professional's medical school graduation year
Primary Specialty OBSTETRICS/GYNECOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name TEXOMA WOMENS CLINIC PA
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 7315942109
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 5
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 1339 E ST
Group Practice or individual's line 1 address
Line 2 Street Address GRAHAM MEDICAL ASSOCIATES SPECIALTY
Group Practice or individual's line 2 address
City GRAHAM
Group Practice or individual's city
State TX
Group Practice or individual's state
Zip Code 764504228
Group Practice or individual's zip code (9 digits when available)
Phone Number 9407238151
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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