Philip a. Moore, M.D., P.a.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

F1835 Issued in TX

Legal business name

PHILIP A. MOORE, M.D., P.A.

Practice address

1600 W College St
Suite LL20
Grapevine, TX 76051-3580

Phone

(817) 488-5170

Fax

(817) 488-6270

NPI assigned

Mar 30, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Philip Alan Moore, M.D.NPI 1053346817

Title

Owner

Phone

(817) 488-5170

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Philip Alan Moore, M.D.

  • Surgery Physician
  • Grapevine, TX
  • NPI 1053346817
  NPD (past) Authorized official

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1730478744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST",
            "address_2": "SUITE LL20",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513580",
            "telephone_number": "817-488-5170",
            "fax_number": "817-488-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST",
            "address_2": "SUITE LL20",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513580",
            "telephone_number": "817-488-5170",
            "fax_number": "817-488-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP A. MOORE, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-488-5170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "F1835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0362543",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Personic Woundcare PLLC
• Jennifer Lee Peters
• Pat Andrew Peters, MD
• Theodore Thomas Peters, M.D.
• Patrick Thien an Pham
• Aminat Y Phillips, NP
• Phoenix One Health Solutions LLC
• Sylvia Lois Pierce
• Sharon Johnston Pignolet, D.C.
• Cassandra Pineda

• Surgery Physician in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.