Moczygemba, Daryl Ray

Moczygemba, Daryl Ray is an individual health care provider with primary practice located at 1301 Barbara Jordan Blvd Suite #401, Austin TX 78723-3077. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as his primary health care specialty. Moczygemba, Daryl Ray can be contacted via phone (512) 628-1900.

Contact Information

Primary practice address
1301 Barbara Jordan Blvd Suite #401 Austin TX 78723-3077
Fax: (512) 628-1901
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 619203 Texas

Profile Details

NPI number 1780730770
LBN Legal business name Moczygemba, Daryl Ray
Credentials MSN, RN, CPNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Apr 8th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780730770 NPPES
Texas MEDICAID 195759905

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