MEDICARE: ABIGAIL MOORE MS CCC SLP

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1932825189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL MOORE MS CCC SLP

Provider Business Mailing Address
First Line	:	4102 GARDENDALE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-7506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12421 TANNER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77041-6505
Country	:	US
Telephone Number	:	713-849-8250
Fax Number	:

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

Provider Enumeration Date	:	10/18/2022
Last Update Date	:	10/18/2022

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Directions to “ ABIGAIL MOORE MS CCC SLP” Practice Location

Language	Start Address	Practice Location

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