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NPI Code Detail

MEDICARE: ADAM MOODY APRN, FNP-C, CEN

MEDICARE: ADAM MOODY APRN, FNP-C, CEN
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
1163W00000XRegistered Nurse740186TX
2363LF0000XFamily Nurse PractitionerAP70058974WA
3363LF0000XFamily Nurse Practitioner1113533TX

General Provider Information

NPI Number : 1881553360
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM MOODY APRN, FNP-C, CEN
Provider Business Mailing Address
First Line : 10318 WESTFIELD PL
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78240-3580
Country : US
Telephone Number : 832-512-3062
Fax Number :
Provider Business Practice Location Address
First Line : 7400 MERTON MINTER ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-4404
Country : US
Telephone Number : 210-617-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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