Organization Active NPI

Moses E Wilcox Sr MD PA

  • Clinic/Center
  • Nederland, TX
National Provider Identifier
1205071602
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
J7728 Issued in TX
Legal business name
MOSES E WILCOX SR MD PA
Practice address
1120 S 27TH St
Nederland, TX 77627-6224
Phone
(409) 727-0794
Fax
(409) 727-6030
NPI assigned
Dec 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
Dr. Moses Edward Wilcox Sr., MDNPI 1033192901
Title
Ceo
Phone
(409) 727-0794

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X J7728 TX Primary

Addresses

Primary practice location

1120 S 27TH St
Nederland, TX 77627-6224

Mailing address

1120 S 27TH St
Nederland, TX 77627-6224
Phone (409) 727-0794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100408000213 TX Part B Supplier - Clinic/Group Practice 9032245634 Receives reassigned benefits from 1 practitioner
Practice locations: Nederland, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0908597Moses E Wilcox Sr MD1120 S 27TH Street, Nederland, TX 77627Provider-performed microscopyNov 8, 2027

National Provider Directory

National Provider Directory

Locations

1120 S 27th St
Nederland, TX 77627
Phone (409) 727-0794

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1229126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1205071602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S 27TH ST",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276224",
            "telephone_number": "409-727-0794",
            "fax_number": "409-727-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S 27TH ST",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776276224",
            "telephone_number": "409-727-0794",
            "fax_number": "409-727-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES E WILCOX SR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-13",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "MOSES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "409-727-0794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "J7728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nederland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.