Moore Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MOORE DERMATOLOGY PLLC

Practice address

2525 W Bellfort Ave Ste 105
Houston, TX 77054-5024

Phone

(713) 741-3376

Fax

(713) 741-9423

NPI assigned

May 16, 2024

Last updated

May 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Omni McCluney, PA-C, MMSC, MPHNPI 1689005860

Title

Physician Assistant

Phone

(713) 741-3376

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Omni McCluney, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Houston, TX
  • NPI 1689005860
  Medicare reassignment Care Compare group Authorized official
• Milton Rahmon Moore, M.D.

  • Dermatology Physician
  • San Antonio, TX
  • NPI 1871888545
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1578312054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 W BELLFORT AVE STE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770545024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W BELLFORT AVE STE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770545024",
            "telephone_number": "713-741-3376",
            "fax_number": "713-741-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "MCCLUNEY",
        "authorized_official_first_name": "OMNI",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "713-741-3376",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PA-C, MMSC, MPH"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mooon Healthcare Services, Inc
• Moore Guderian Mindful Solutions (Think Change Counseling)
• Moore Health Services
• Deshantra Kameshel Moore Lewis, LCSW-S
• Moore Mental Health & Behavioral Services PLLC
• Moore Resiliency Behavioral Health

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.