| Dr Michael Moak, DO | |
|
3851 Roger Brooke Dr, Mche-qd (credentials), Fort Sam Houston, TX 78234-4501 | |
| (210) 916-3290 | |
| Not Available |
| Full Name | Dr Michael Moak |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 3851 Roger Brooke Dr, Fort Sam Houston, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902897267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | BP10024057 (Texas) | Primary |
| Entity Name | Radadvantage A Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376719666 PECOS PAC ID: 2163597899 Enrollment ID: O20081103000272 |
| Entity Name | Lima Memorial Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457474900 PECOS PAC ID: 1254232184 Enrollment ID: O20240208003819 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Moak, DO 3634 Eagle Canyon Dr, San Antonio, TX 78247-4460 Ph: (210) 495-0313 | Dr Michael Moak, DO 3851 Roger Brooke Dr, Mche-qd (credentials), Fort Sam Houston, TX 78234-4501 Ph: (210) 916-3290 |
Dr. Michael Day Dullea, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 3851 Roger Brooke Dr, Mche-qd (credentials), Fort Sam Houston, TX 78234 Phone: 210-916-5046 | |
Dr. Francis Joseph Cloran, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-916-4218 | |
Dr. Emilio Fentanes, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-539-8414 | |
Dr. Jayanta Krishna Chaudhuri, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-539-9582 | |
Dr. Anthony Wayne Allen, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3851 Roger Brooke Dr, Brooke Army Medical Center Mche-qd/credentials, Fort Sam Houston, TX 78234 Phone: 210-916-3573 | |
Dr. Shane Blake Anderson, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3551 Roger Brooke Dr, Brooke Army Medical Center, Fort Sam Houston, TX 78234 Phone: 210-916-4062 | |
Rachel Tobillo, MD Radiology Medicare: Medicare Enrolled Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-916-5046 |