MEDICARE: TRONDA LEE MOSS MS

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
1	235Z00000X	Speech-Language Pathologist	7314	NC
2	235Z00000X	Speech-Language Pathologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366593600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRONDA LEE MOSS MS

Provider Business Mailing Address
First Line	:	100 N UNIVERSITY DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-1360
Country	:	US
Telephone Number	:	817-815-4726
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 LOWERY RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76120-2452
Country	:	US
Telephone Number	:	817-815-4726
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	04/25/2024

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Directions to “ TRONDA LEE MOSS MS” Practice Location

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