Provider Demographics
NPI:1184950503
Name:MOORE, CURTISS
Entity type:Individual
Prefix:
First Name:CURTISS
Middle Name:
Last Name:MOORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 E BROAD ST STE 522
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6417
Mailing Address - Country:US
Mailing Address - Phone:682-242-8970
Mailing Address - Fax:214-947-8668
Practice Address - Street 1:2800 E BROAD ST STE 522
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6417
Practice Address - Country:US
Practice Address - Phone:682-242-8970
Practice Address - Fax:214-947-8668
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2498207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease