| Doctor Name: | MATTHEW MOON |
| NPI Number: | 1023406816 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CRNA |
| License Number: | |
| Business Practice Address: | 6606 Lbj Fwy Ste 200 Dallas, TX - 752406524 |
| Business Phone Number: | 9727155000 |
| Business Fax Number: | 9727159976 |
| Mailing Address: | Po Box 650865, DALLAS |
| State: | TX |
| Postal Code: | 752650865 |
| Phone Number: | 9727155000 |
| Fax Number: | 9727159976 |
| NPI Enumeration Date: | 12/31/2014 |
| NPI Last Update Date: | 11/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |