Provider Demographics
NPI:1437457249
Name:MOSS, MICHAEL DON (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DON
Last Name:MOSS
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5815 GULF FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77023-5362
Mailing Address - Country:US
Mailing Address - Phone:713-643-0012
Mailing Address - Fax:713-643-5808
Practice Address - Street 1:5815 GULF FWY STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-5362
Practice Address - Country:US
Practice Address - Phone:713-643-0012
Practice Address - Fax:713-643-5808
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH048005-23363LF0000X
TXAP139907363LF0000X
VT101-0091635363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care