| Doctor Name: | MR. THOMAS TAYLOR MOORE |
| NPI Number: | 1417382615 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. |
| License Number: | |
| Business Practice Address: | 111 Arrowhead Dr Pauls Valley, OK - 730755301 |
| Business Phone Number: | 4053312300 |
| Business Fax Number: | 4053312302 |
| Mailing Address: | 18202 W 20th St N, HASKELL |
| State: | OK |
| Postal Code: | 744362800 |
| Phone Number: | 9186393903 |
| Fax Number: | |
| NPI Enumeration Date: | 09/06/2013 |
| NPI Last Update Date: | 09/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |