| Wayne Moldovan Md Professional Association | |
|
6550 Fannin St Suite 2415 Houston TX 77030-2717 | |
| (713) 790-0911 | |
| Not Available |
| Full Name | Wayne Moldovan Md Professional Association |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6550 Fannin St, Houston, Texas |
| Authorized Official Name and Position | Wayne Scott Moldovan (CEO) |
| Authorized Official Contact | 7137900911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne Moldovan Md Professional Association 6550 Fannin St Suite 2415 Houston TX 77030-2717 Ph: (713) 790-0911 | Wayne Moldovan Md Professional Association 6550 Fannin St Suite 2415 Houston TX 77030-2717 Ph: (713) 790-0911 |
| NPI Number | 1093131542 |
|---|---|
| Provider Enumeration Date | 03/07/2014 |
| Last Update Date | 03/07/2014 |
| Medicare PECOS PAC ID | 2961635313 |
|---|---|
| Medicare Enrollment ID | O20140509000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093131542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | P8163 (Texas) | Primary |
| Provider Name | Wayne S Moldovan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194040451 PECOS PAC ID: 9335372796 Enrollment ID: I20140509000826 |
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