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NPI Code Detail

MEDICARE: MOSES ODAI DO

MEDICARE: MOSES ODAI DO
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
1207Q00000XFamily Medicine PhysicianV7691TX

General Provider Information

NPI Number : 1841992427
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOSES ODAI DO
Provider Business Mailing Address
First Line : 900 8TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3902
Country : US
Telephone Number : 817-992-6158
Fax Number :
Provider Business Practice Location Address
First Line : 900 8TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3902
Country : US
Telephone Number : 817-992-6158
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2023
Last Update Date : 03/16/2026

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Directions to “ MOSES ODAI DO” Practice Location

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