Provider Demographics
NPI:1164922894
Name:MOORE, BELINDA SUMMERS (LVN)
Entity Type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:SUMMERS
Last Name:MOORE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 FM 328
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:75949-3019
Mailing Address - Country:US
Mailing Address - Phone:936-414-0549
Mailing Address - Fax:
Practice Address - Street 1:3180 FM 328
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:TX
Practice Address - Zip Code:75949-3019
Practice Address - Country:US
Practice Address - Phone:936-414-0549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305615164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse