MEDICARE: MRS. PRINSCILLA MOORE

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	374J00000X	Doula		TX

General Provider Information

NPI Number	:	1558288688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PRINSCILLA MOORE

Provider Business Mailing Address
First Line	:	PO BOX 1533
Second Line	:
City	:	PROSPER
State	:	TX
Zip	:	75078-3207
Country	:	US
Telephone Number	:	248-445-0126
Fax Number	:

Provider Business Practice Location Address
First Line	:	5600 ROSS AVE STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-7926
Country	:	US
Telephone Number	:	469-828-1833
Fax Number	:

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

Provider Enumeration Date	:	06/30/2026
Last Update Date	:	06/30/2026

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Directions to “ MRS. PRINSCILLA MOORE ” Practice Location

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