Provider Demographics
NPI:1568416188
Name:MOSELEY, KARAN RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:KARAN
Middle Name:RUTH
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 FLOWER GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-3920
Mailing Address - Country:US
Mailing Address - Phone:817-461-1702
Mailing Address - Fax:817-461-1772
Practice Address - Street 1:1001 N WALDROP DR
Practice Address - Street 2:SUITE 402
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4705
Practice Address - Country:US
Practice Address - Phone:817-461-1702
Practice Address - Fax:817-461-1772
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3626174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1144834 04Medicaid
TX8D8315Medicare ID - Type Unspecified
TXB24994Medicare UPIN