NPIMap

Organization Active NPI

Mark S Moeller MD PA

  • Psychiatry Physician
  • Bellaire, TX
National Provider Identifier
1326013343
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
H6443 Issued in TX
Legal business name
MARK S MOELLER MD PA
Practice address
6300 West Loop South
Ste 680
Bellaire, TX 77401
Phone
(713) 661-4670
Fax
(713) 661-4672
NPI assigned
Feb 22, 2006
Reactivated
Oct 6, 2011
Last updated
Oct 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Authorized official

Name
Dr. Mark Stephen Moeller, MDNPI 1053590133
Title
Owner
Phone
(713) 661-4670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X H6443 TX Primary

Addresses

Primary practice location

6300 West Loop South
Ste 680
Bellaire, TX 77401

Mailing address

6300 West Loop South
Ste 680
Bellaire, TX 77401
Phone (713) 661-4670

Other identifiers 1

IdentifierTypeStateIssuer
128313702MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317859200000",
    "number": "1326013343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 WEST LOOP SOUTH",
            "address_2": "STE 680",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "77401",
            "telephone_number": "713-661-4670",
            "fax_number": "713-661-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 WEST LOOP SOUTH",
            "address_2": "STE 680",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "77401",
            "telephone_number": "713-661-4670",
            "fax_number": "713-661-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S MOELLER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2011-10-06",
        "deactivation_date": "2007-12-19",
        "reactivation_date": "2011-10-06",
        "status": "A",
        "authorized_official_last_name": "MOELLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-661-4670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H6443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128313702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.