GREGORY TODD MOORE, DO PA
Medical Practice in Ennis, TX

License number
Texas N0287
Category
Medical Practice
Type
Sports Medicine
Owner
Name: DR. GREGORY TODD MOORE D.O.
Title: ORTHOPEDIC SURGEON
Phone: (806) 239-7820
Address
Address 2
2203 W. Lampasas St SUITE 114, Ennis, TX 75119
8217 Avenue U APT 5205, Lubbock, TX 79423
National Provider ID: 1295961233
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GREGORY TODD MOORE, D.O., PA

905 Vicksburg Dr, Ennis, TX 75119

Status:
Inactive
Registration:
May 22, 2009
State ID:
0801126163
Business type:
Professional Association
Director , Member, President:
Gregory Todd Moore (Director , Member, President)
Agent:
Gregory Moore,1810 Coyote Ct, Midlothian, TX 76065 (Physical)
TIN:
32039574267

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