Provider Demographics
NPI:1225025729
Name:MOORHEAD, JOHN CARY (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CARY
Last Name:MOORHEAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10740 N GESSNER DR
Mailing Address - Street 2:STE 310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1240
Mailing Address - Country:US
Mailing Address - Phone:281-897-0416
Mailing Address - Fax:281-890-8908
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:STE 225
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2518
Practice Address - Country:US
Practice Address - Phone:713-467-5787
Practice Address - Fax:713-467-0965
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7820207YS0012X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX224188OtherBEECHSTREET
TX103407602Medicaid
TX040010190Medicare PIN
TX103407602Medicaid
TX224188OtherBEECHSTREET