Mitzi Moore

Primary specialty

PharmacistTaxonomy code 183500000X

License

31251 Issued in TX

Practice address

107 W Rankin Rd
Houston, TX 77090-6928

Phone

(281) 872-0612

NPI assigned

Aug 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Walgreen Co

  • Pharmacy
  • Houston, TX
  • NPI 1861409872
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1417569468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W RANKIN RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770906928",
            "telephone_number": "281-872-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W RANKIN RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770906928",
            "telephone_number": "281-872-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MITZI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "31251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PHARMACY",
            "identifier": "31251",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rxm.15155@store.walgreens.com",
            "affiliation": "Y",
            "affiliationName": "WALGREEN CO",
            "address_1": "107 W Rankin Rd",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770906928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael John Moore, P.A.
• Michael William Shaw Moore III, M.D.
• Michael Zachary Moore, MD
• Mikayla Moore
• Mitchell Graham Moore, MD
• Nicole Marie Moore, DDS
• Paige Moore, PHARMD
• Peter Moore
• Reyna Moore, D.C.
• Rhonda Kay Moore, LPC

• Pharmacist in Houston, TX
• Providers in Houston, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.