MARIBETH DUDLEY MOORE (NPI# 1376530758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376530758 |
| Entity Type | Individual |
| Full Name | MARIBETH DUDLEY MOORE |
| Credential | D.O. |
| Practice Address |
800 Riverwood Ct Suite 105 Conroe TX 77304-2890 |
| Practice Telephone | 9367604454 |
| Practice Fax Number | 9367604415 |
| Mailing Telephone | 9367604454 |
| Mailing Fax Number | 9367604415 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2011-04-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | K0529 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 046741706 | 05 |
| Street Address |
800 RIVERWOOD CT SUITE 105 |
| City | CONROE |
| State | TX |
| Zip Code | 77304-2890 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699771675 | John Edward Bock | Specialist | 800 Riverwood Ct, Ste 104, Conroe, TX 77304-2824 | 2005-06-23 |
| 1194366880 | Kerry I Kuperman | Behavioral Analyst | 800 Riverwood Ct, Conroe, TX 77304-2890 | 2019-10-03 |
| 1265800031 | Camille W. Clemens-clayton | Psychologist | 800 Riverwood Ct, Conroe, TX 77304-2890 | 2015-09-09 |
| 1073822144 | Bang-ning Lee | Physician Assistant | 800 Riverwood Ct, Ste 100, Conroe, TX 77304 | 2010-10-06 |
| 1841473303 | Marianne Hitter | Registered Nurse | 800 Riverwood Ct, Conroe, TX 77304-2890 | 2007-12-07 |
| 1710902978 | Yavonne Qwinshell Martinez | Pharmacist | 800 Riverwood Ct, Ste. 100, Conroe, TX 77304-2890 | 2006-07-12 |
| 1366497364 | Family Healthcare Affiliates Pllc | Family Medicine | 800 Riverwood Ct, Suite 105, Conroe, TX 77304-2890 | 2006-05-24 |
| 1811984321 | Kara Kern | Family Medicine | 800 Riverwood Ct, Suite 105, Conroe, TX 77304-2890 | 2005-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194348649 | Neuropsychiatric Hospital of Greater Houston, LLC | Psychiatric Hospital | 1317 South Loop Road 336 West, Conroe, TX 77304 | 2020-05-19 |
| 1780148676 | Muve - Conroe Ambulatory Surgical Center, LLC | Clinic/Center | 1246 N Farm To Market 3083 Rd W, Conroe, TX 77304 | 2019-01-25 |
| 1922591411 | Bradley Leiker II | Dentist | 381 South Loop 336 West Suite 500, Conroe, TEXAS 77304 | 2018-06-11 |
| 1598266009 | Chapman Pain Consultants | Anesthesiology | 4015 I45 North, Suite 230-1, Conroe, TX 77304 | 2018-02-21 |
| 1063932366 | Jonathan Garcia | Specialist/Technologist | 1716 Summergate Drive, Conroe, TX 77304 | 2017-06-27 |
| 1932634169 | 3083 Imaging LLC | Clinic/Center | 1246 N Fm 3083 West, Conroe, TX 77304 | 2017-04-25 |
| 1881138758 | Bolt Urgent Care and Imaging Center, LLC | Clinic/Center | 1246 Fm 3083 West, Conroe, TX 77304 | 2016-12-13 |
| 1497106272 | The Rio At Conroe, LLC | Skilled Nursing Facility | 604 South Conroe Medical Drive, Conroe, TX 77304 | 2016-06-23 |
| 1093165615 | Melanie Kay Plaster | Behavioral Analyst | 2626 Silver Shadow, Conroe, TX 77304 | 2016-06-14 |
| 1508249798 | Conroe Willis Family Medicine, Pllc | Family Medicine | 4015 I 45 N Ste 220, Conroe, TX 77304 | 2015-07-07 |
| Find all providers in zip 77304 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407490543 | Tamara Marie Oluwafemi | Family Medicine | 10051 S Whimbrel Cir, Conroe, TX 77385-0010 | 2019-11-01 |
| 1538625363 | Kathy Jean Garvin | Family Medicine | 3000 W Davis St Ste 1, Conroe, TX 77304-2073 | 2019-02-17 |
| 1659885069 | Greater Houston Family Medicine, Pllc | Family Medicine | 100 Medical Center Blvd Ste 104, Conroe, TX 77304-2821 | 2017-11-21 |
| 1487178208 | Cure-tex Clinic | Family Medicine | 8000 Highway 242 # 16, Conroe, TX 77385-4342 | 2017-08-02 |
| 1902336456 | Elizabeth Flora Slauter | Family Medicine | 690 S Loop 336 W Ste 222, Conroe, TX 77304-3320 | 2017-06-18 |
| 1508249798 | Conroe Willis Family Medicine, Pllc | Family Medicine | 4015 I 45 N Ste 220, Conroe, TX 77304 | 2015-07-07 |
| 1063774842 | Justin Grissom | Family Medicine | 4015 I H 45 N Ste 100, Conroe, TX 77304 | 2012-06-08 |
| 1346533841 | Simi Koshy | Family Medicine | 503 Medical Center Blvd Ste 100, Conroe, TX 77304-2928 | 2011-05-17 |
| 1225298391 | Santosh R Reddy | Family Medicine | 17002 Gleneagle Dr. South, Conroe, TX 77385 | 2008-06-12 |
| 1316132335 | Miguel Flores & Associates, P.a. | Family Medicine | 804 W Dallas St, Ste #4, Conroe, TX 77301-2248 | 2007-09-12 |
| Find all providers in CONROE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.