Moore, Mark Gregory

Moore, Mark Gregory is an individual health care provider with primary practice located at 2000 S Palestine St , Athens TX 75751-5610. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Moore, Mark Gregory can be contacted via phone (903) 677-1000.

Contact Information

Primary practice address
2000 S Palestine St Athens TX 75751-5610
Phone: (903) 677-1000
Fax: (903) 677-5586
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 548063 Texas

Profile Details

NPI number 1144210188
LBN Legal business name Moore, Mark Gregory
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Apr 6th, 2010 - about 14 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1144210188 NPPES
Texas MEDICAID 0026460-01

Popular Providers