Provider Demographics
NPI:1225694847
Name:MOORE NATURAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:MOORE NATURAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:LM
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-655-3570
Mailing Address - Street 1:347 ANGEL FISH DR
Mailing Address - Street 2:
Mailing Address - City:PALACIOS
Mailing Address - State:TX
Mailing Address - Zip Code:77465-0539
Mailing Address - Country:US
Mailing Address - Phone:512-655-3570
Mailing Address - Fax:
Practice Address - Street 1:3115 S 1ST ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8847
Practice Address - Country:US
Practice Address - Phone:512-655-3570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty