Provider Demographics
NPI:1588632046
Name:MOSCRIP, CORDELIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:CORDELIA
Middle Name:A
Last Name:MOSCRIP
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Gender:F
Credentials:MD
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Mailing Address - Street 1:527 N LEONA ST
Mailing Address - Street 2:2ND FLOOR EXPRESS MED CLINIC
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3110
Mailing Address - Country:US
Mailing Address - Phone:210-358-3460
Mailing Address - Fax:210-358-5944
Practice Address - Street 1:527 N LEONA ST
Practice Address - Street 2:2ND FLOOR EXPRESS MED CLINIC
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3110
Practice Address - Country:US
Practice Address - Phone:210-358-3460
Practice Address - Fax:210-358-5944
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2011-10-10
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Provider Licenses
StateLicense IDTaxonomies
TXK6488207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142790801Medicaid
TX142790801Medicaid
TXH24170Medicare UPIN