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Shane Moore
Family Nurse Practitioner in Waco, Texas
NPI 1417426529

Shane Moore is a Family Nurse Practitioner based in Killeen, TX and is specialized in Family. Shane Moore practices in Waco, TX. The NPI Number for Shane Moore is 1417426529 and holds a License No. AP139172 (Texas).

The current practice location address for Shane Moore is 7030 New Sanger Ave Ste 204, Waco, TX and can be reached out via phone at 254-245-9175 and via fax at 254-213-7771.

Location: 7030 New Sanger Ave Ste 204, Waco, TX, 76547-1538
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417426529
Provider Name
Shane Moore
Credential
Provider Entity Type
Individual
Gender
Male
Address
7030 New Sanger Ave Ste 204, Waco, TX, 76547-1538
Phone Number
254-245-9175
Fax Number
254-213-7771
Provider Enumeration Date
11/19/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AP139172 01 TX LICENSE
institution
Provider Business Practice Location Address Details
Address
7030 New Sanger Ave Ste 204
City
Waco
State
Texas
Zip
76712-4074
Phone Number
254-245-9175
Fax Number
254-213-7771
person
Provider Business Mailing Address Details
Address
7030 New Sanger Ave Ste 204
City
Waco
State
Texas
Zip
76712-4074
Phone Number
254-245-9175
Fax Number
254-213-7771
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
AP139172 (Texas)
Definition
Definition to come...
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