Provider Demographics
NPI:1326305749
Name:MOSHER, JULIE MICHELLE (R EEG, EPT, CNIM)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MICHELLE
Last Name:MOSHER
Suffix:
Gender:F
Credentials:R EEG, EPT, CNIM
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Mailing Address - Street 1:451 CONSTELLATION BLVD
Mailing Address - Street 2:APT 1104
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2974
Mailing Address - Country:US
Mailing Address - Phone:713-623-3071
Mailing Address - Fax:
Practice Address - Street 1:5420 WEST LOOP S
Practice Address - Street 2:SUITE 3100
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2107
Practice Address - Country:US
Practice Address - Phone:713-581-6950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX2325246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic