Provider Demographics
NPI:1295966000
Name:MOORE, RICHARD H I (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:H
Last Name:MOORE
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1501 BURNET RD
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-8520
Mailing Address - Country:US
Mailing Address - Phone:325-649-3640
Mailing Address - Fax:325-646-5459
Practice Address - Street 1:123 S PARK DR
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5917
Practice Address - Country:US
Practice Address - Phone:325-649-3640
Practice Address - Fax:325-649-3646
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE23012083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC19557Medicare UPIN