Moore, Charlie Jim
Moore, Charlie Jim is an sole proprietor health care provider with primary practice located at 2481 I 40 W , Amarillo TX 79109. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moore, Charlie Jim can be contacted via phone (806) 358-2205.Contact Information
Primary practice address
2481 I 40 W
Amarillo TX 79109
Phone: (806) 358-2205
Fax: (806) 463-2907
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2740TG | Texas |
Profile Details
| NPI number | 1003868670 |
|---|---|
| LBN Legal business name | Moore, Charlie Jim |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 16th, 2006 |
| Last updated | Jul 3rd, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003868670 | NPPES |
| Texas | MEDICAID | 1331696-07 |
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