Roy Allen Moll Jr.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1002614 Issued in TX

Practice address

161 Main St
Deport, TX 75435-2560

Phone

(903) 209-8981

NPI assigned

Apr 16, 2022

Last updated

Apr 16, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: rx@globaltech-pse.com

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

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650067200000",
    "number": "1992448005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MAIN ST",
            "city": "DEPORT",
            "state": "TX",
            "postal_code": "754352560",
            "telephone_number": "903-209-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MAIN ST",
            "city": "DEPORT",
            "state": "TX",
            "postal_code": "754352560",
            "telephone_number": "903-209-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLL",
        "first_name": "ROY",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-16",
        "last_updated": "2022-04-16",
        "certification_date": "2022-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "1002614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rx@globaltech-pse.com",
            "affiliation": "N",
            "endpointDescription": "RX",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "161 Main St",
            "city": "Deport",
            "state": "TX",
            "country_code": "US",
            "postal_code": "754352560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Trousdale Foundation of Deport, Inc. (Deport Nursing Center)

• Durable Medical Equipment & Medical Supplies in Deport, TX
• Providers in Deport, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2022; 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.