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NPI Code Detail

MEDICARE: DR. CHARLES ROBERT MOORE M.D.

MEDICARE: DR. CHARLES ROBERT MOORE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology PhysicianD0717TX

General Provider Information

NPI Number : 1215053426
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES ROBERT MOORE M.D.
Provider Business Mailing Address
First Line : 926 N WILCREST DR
Second Line :
City : HOUSTON
State : TX
Zip : 77079-3504
Country : US
Telephone Number : 713-984-9777
Fax Number :
Provider Business Practice Location Address
First Line : 926 N WILCREST DR
Second Line :
City : HOUSTON
State : TX
Zip : 77079-3504
Country : US
Telephone Number : 713-984-9777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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Directions to “ DR. CHARLES ROBERT MOORE M.D.” Practice Location

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