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NPI Code Detail

MEDICARE: RANDY MOORE R.PH.

MEDICARE: RANDY MOORE R.PH.
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
1183500000XPharmacist23585TX

General Provider Information

NPI Number : 1619204856
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY MOORE R.PH.
Provider Business Mailing Address
First Line : 8310 ABRAMS RD
Second Line :
City : DALLAS
State : TX
Zip : 75243-7604
Country : US
Telephone Number : 214-503-6286
Fax Number :
Provider Business Practice Location Address
First Line : 8310 ABRAMS RD
Second Line :
City : DALLAS
State : TX
Zip : 75243-7604
Country : US
Telephone Number : 214-503-6286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2009
Last Update Date : 11/09/2009

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Directions to “ RANDY MOORE R.PH.” Practice Location

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