MEDICARE: SYDNEY DUNHAM MOORE PA

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	363A00000X	Physician Assistant
2	363AS0400X	Surgical Physician Assistant	PA19443	TX

General Provider Information

NPI Number	:	1952993867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY DUNHAM MOORE PA

Provider Business Mailing Address
First Line	:	929 GESSNER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2515
Country	:	US
Telephone Number	:	713-465-1211
Fax Number	:

Provider Business Practice Location Address
First Line	:	7400 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1920
Country	:	US
Telephone Number	:	713-465-1211
Fax Number	:

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

Provider Enumeration Date	:	02/11/2021
Last Update Date	:	03/23/2026

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Directions to “ SYDNEY DUNHAM MOORE PA” Practice Location

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