Todd O Moore, MD, PA

Primary specialty

Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X

License

L7489 Issued in TX

Practice address

711 E Lamar Blvd Ste 200
Arlington, TX 76011-3800

Phone

(817) 795-7546

Fax

(817) 226-7546

NPI assigned

Aug 14, 2006

Last updated

May 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Angela Yen Moore, MD PA

  dba Arlington Center for Dermatology

  • Dermatology Physician
  • Arlington, TX
  • NPI 1265507941
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1083627020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 E LAMAR BLVD STE 200",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760113800",
            "telephone_number": "817-795-7546",
            "fax_number": "817-226-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E LAMAR BLVD STE 200",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760113800",
            "telephone_number": "817-795-7546",
            "fax_number": "817-226-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TODD",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "TX",
            "license": "L7489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Remis Mark Moore, PA-C
• Rhonda Moore, MA, QMHP, LPC-INTERN
• Sarah Moore
• Talitha C. Moore, LPC
• Tashia Moore, LCSW
• Lindsay Latronya Moorehead, PA
• Jasmine Yesenia Morales-Lara
• Adrian Morales
• Ana Jasmine Morales
• Christine Morales, LCSW

• Dermatology Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.