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Dyese Moody
Military Health Care Provider in Jbsa Ft Sam Houston, Texas
NPI 1770341992

Dyese Moody is a Military Health Care Provider based in Jbsa Ft Sam Houston, TX. Dyese Moody practices in Jbsa Ft Sam Houston, TX. The NPI Number for Dyese Moody is 1770341992 and holds a License No. (Texas).

The current practice location address for Dyese Moody is 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX and can be reached out via phone at 210-292-3410.

Location: 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX, 78234-4504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770341992
Provider Name
Dyese Moody
Credential
Provider Entity Type
Individual
Gender
Female
Address
3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX, 78234-4504
Phone Number
210-292-3410
Fax Number
Provider Enumeration Date
03/12/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
3551 Roger Brooke Dr
City
Jbsa Ft Sam Houston
State
Texas
Zip
78234-4504
Phone Number
210-292-3410
Fax Number
person
Provider Business Mailing Address Details
Address
3551 Roger Brooke Dr
City
Jbsa Ft Sam Houston
State
Texas
Zip
78234-4504
Phone Number
210-292-3410
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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