Provider Demographics
NPI:1639149263
Name:MOORE, SCOTT ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALAN
Last Name:MOORE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:502 MADISON OAK DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4084
Mailing Address - Country:US
Mailing Address - Phone:210-483-8883
Mailing Address - Fax:210-474-1740
Practice Address - Street 1:502 MADISON OAK DR
Practice Address - Street 2:SUITE 310
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4084
Practice Address - Country:US
Practice Address - Phone:210-483-8883
Practice Address - Fax:210-474-1470
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2012-12-28
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Provider Licenses
StateLicense IDTaxonomies
TXJ8680207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology