Provider Demographics
NPI:1639428980
Name:MOORE MENTAL HEALTH & BEHAVIORAL SERVICES PLLC
Entity Type:Organization
Organization Name:MOORE MENTAL HEALTH & BEHAVIORAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:281-705-5620
Mailing Address - Street 1:PO BOX 90446
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77290-0446
Mailing Address - Country:US
Mailing Address - Phone:281-919-1059
Mailing Address - Fax:281-271-8927
Practice Address - Street 1:17030 NANES DR STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2504
Practice Address - Country:US
Practice Address - Phone:281-415-1280
Practice Address - Fax:281-271-8927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-02
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36006103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty