Individual provider Active NPI

Sidney Moss

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Houston, TX
National Provider Identifier
1679012744
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
32062681260 Issued in TX
Practice address
2425 Capitol St Apt 2130
Houston, TX 77003-3179
Phone
(713) 380-1011
NPI assigned
Feb 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 32062681260 TX Primary

Addresses

Primary practice location

2425 Capitol St Apt 2130
Houston, TX 77003-3179

Mailing address

2425 Capitol St Apt 2130
Houston, TX 77003-3179
Phone (713) 380-1011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
32062681260TXMDIntellectual and/or Developmental Disabilities Residential Treatment Facility

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1679012744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 CAPITOL ST APT 2130",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770033179",
            "telephone_number": "713-380-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 CAPITOL ST APT 2130",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770033179",
            "telephone_number": "713-380-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "SIDNEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TX",
            "license": "32062681260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.