Provider Demographics
NPI:1497967046
Name:WILLIAM H. MOORE, M.D., P.A.
Entity Type:Organization
Organization Name:WILLIAM H. MOORE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HUME
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-368-6341
Mailing Address - Street 1:8350 N CENTRAL EXPY
Mailing Address - Street 2:SUITE M-1025
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1600
Mailing Address - Country:US
Mailing Address - Phone:214-368-6341
Mailing Address - Fax:214-368-5803
Practice Address - Street 1:8350 N CENTRAL EXPY
Practice Address - Street 2:SUITE M-1025
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-1600
Practice Address - Country:US
Practice Address - Phone:214-368-6341
Practice Address - Fax:214-368-5803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9243261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF40077Medicare UPIN