Individual provider Active NPI

Michael Moak, D.O.

  • Diagnostic Radiology Physician
  • Fort Sam Houston, TX
National Provider Identifier
1902897267
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
BP10024057 Issued in TX
Practice address
3851 Roger Brooke Dr
McHe-QD (Credentials)
Fort Sam Houston, TX 78234-4501
Phone
(210) 916-3290
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X BP10024057 TX Primary

Addresses

Primary practice location

3851 Roger Brooke Dr
McHe-QD (Credentials)
Fort Sam Houston, TX 78234-4501

Mailing address

3634 Eagle Canyon Dr
San Antonio, TX 78247-4460
Phone (210) 495-0313

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
BP10024057TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Radiology Services of West Florida, Inc. Diagnostic Radiology Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Integris Southwest Associates Past Accepting new patients
Radiology Associates of North Texas PA Diagnostic Radiology Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Eastpointe Radiologists, PC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902897267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3634 EAGLE CANYON DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782474460",
            "telephone_number": "210-495-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 ROGER BROOKE DR",
            "address_2": "MCHE-QD (CREDENTIALS)",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344501",
            "telephone_number": "210-916-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAK",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "BP10024057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.