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1417426529
SHANE MOORE
WACO, TX
NPI
1417426529
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX AP139172)
Enumeration Date
2018-11-19
Last Update Date
2020-10-14
Business Address
SHANE MOORE
7030 NEW SANGER AVE STE 204
WACO, TX 76712-4074
Phone number: 254-245-9175
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Mailing Address
SHANE MOORE
PO BOX 11538
KILLEEN, TX 76547-1538
Phone number: 254-245-9177
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