Individual provider Active NPI

Avery Moore, PA

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1174480123
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA20696 Issued in TX
Practice address
18885 Katy Fwy
Houston, TX 77094-1103
Phone
(281) 892-2000
NPI assigned
Jan 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA20696 TX Primary

Addresses

Primary practice location

18885 Katy Fwy
Houston, TX 77094-1103

Mailing address

PO Box 207
Houston, TX 77001-0207
Phone (281) 892-2000

Other practice location 1

215 Kingwood Executive Dr Ste 100
Kingwood, TX 77339-2764
Phone (281) 358-4145

Other practice location 2

2600 North Loop W Ste 100
Houston, TX 77092-8915
Phone (713) 650-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates, LLP PastSince Mar 30, 2025 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1767916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1174480123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770010207",
            "telephone_number": "281-892-2000",
            "fax_number": "888-355-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18885 KATY FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941103",
            "telephone_number": "281-892-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Kingwood Executive Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773392764",
            "country_code": "US",
            "telephone_number": "281-358-4145",
            "fax_number": "888-355-5052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 North Loop W Ste 100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770928915",
            "country_code": "US",
            "telephone_number": "713-650-6900",
            "fax_number": "888-355-5052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AVERY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-09",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA20696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.