Provider Demographics
NPI:1922260884
Name:MOODY, ERIN NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:MOODY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3226 REID DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2519
Mailing Address - Country:US
Mailing Address - Phone:512-658-5729
Mailing Address - Fax:
Practice Address - Street 1:5950 SARATOGA BOULEVARD
Practice Address - Street 2:CHRISTUS SPOHN HOSPITAL -SOUTH
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414
Practice Address - Country:US
Practice Address - Phone:512-658-5729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN73142085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology