Wylie Moody, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

WYLIE MOODY, MD

Practice address

6404 Nursery Dr Ste 201
Victoria, TX 77904-1688

Phone

(832) 330-9162

NPI assigned

Jan 15, 2026

Organization subpart

No

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

Authorized official

Name

Wylie Moody, MDNPI 1740920529

Title

Dermatologist/Owner

Phone

(361) 724-3864

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wylie Masterson Moody, MD

  • Dermatology Physician
  • Victoria, TX
  • NPI 1740920529
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1768435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1184582215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 NURSERY DR STE 201",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779041688",
            "telephone_number": "361-724-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 NURSERY DR STE 201",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779041688",
            "telephone_number": "832-330-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYLIE MOODY, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-15",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "WYLIE",
        "authorized_official_title_or_position": "DERMATOLOGIST/OWNER",
        "authorized_official_telephone_number": "361-724-3864",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.