Provider Demographics
NPI:1508151481
Name:MOORE, MICHAEL WILLIAM SHAW III (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM SHAW
Last Name:MOORE
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2500 TANGLEWILDE ST
Mailing Address - Street 2:STE 160
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2100
Mailing Address - Country:US
Mailing Address - Phone:713-780-9660
Mailing Address - Fax:713-974-3672
Practice Address - Street 1:10740 N GESSNER RD
Practice Address - Street 2:STE 310
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-1240
Practice Address - Country:US
Practice Address - Phone:281-897-0416
Practice Address - Fax:281-890-8908
Is Sole Proprietor?:No
Enumeration Date:2011-06-18
Last Update Date:2021-08-09
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Provider Licenses
StateLicense IDTaxonomies
SCLL33725207Y00000X
TXQ6968207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology