Organization · NPI-2

A Randall Moody II MD PA

Psychiatry & Neurology, Neurology · San Antonio, TX

NPI number1740219682
StatusActive
Last updated in NPPESJul 28, 2013

Details

NPI
1740219682
Entity type
Organization (NPI-2)
Legal business name
A Randall Moody II MD PA
Organization subpart
No
Enumeration date
Jul 2, 2006
Last updated
Jul 28, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, Neurology––Yes

Practice location

5788 Eckhert Rd
Frank M. Tejeda Va Outpatient Clinic, C&P Department
San Antonio, TX 78240-3900

Phone 830-285-4096 · Fax 830-896-3310

Mailing address

5788 Eckhert Rd
Frank M. Tejeda Va Outpatient Clinic, C& P Department
San Antonio, TX 78240-3900

Phone 830-285-4096 · Fax 830-896-3310

Authorized official

Austin Randall Moody
MD
8302854096

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