MEDICARE: TANIKA 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	225700000X	Massage Therapist	036721	TX

General Provider Information

NPI Number	:	1861107633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIKA MOORE

Provider Business Mailing Address
First Line	:	17711 SCARLETT FALLS LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-2156
Country	:	US
Telephone Number	:	469-583-1933
Fax Number	:

Provider Business Practice Location Address
First Line	:	1822 SNAKE RIVER RD STE E
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-7749
Country	:	US
Telephone Number	:	281-789-8970
Fax Number	:

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

Provider Enumeration Date	:	01/17/2023
Last Update Date	:	01/17/2023

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Directions to “ TANIKA MOORE ” Practice Location

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