MARIBETH DUDLEY MOORE D.O. NPI 1376530758

NPI Information

  • NPI: 1376530758
  • Provider Name: MARIBETH DUDLEY MOORE, D.O.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 800 RIVERWOOD CT
    SUITE 105
    CONROE, TX
    ZIP 77304
  • Phone: (936) 760-4454

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NPI Details

Maribeth Dudley Moore, D.O. is a family medicine in Conroe, TX with 31 years of experience. The provider is 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. Maribeth Dudley Moore, D.O. NPI is 1376530758. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduation Year:1995

The provider's business location address is:

800 RIVERWOOD CT
SUITE 105
CONROE, TX
ZIP 77304-890
Phone: (936) 760-4454
Fax: (936) 760-4415

The NPI 1376530758 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Urinalysis, manual test (HCPCS:81002)

The enumeration date for this NPI number is 9/30/2005 and was last updated on 4/13/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineK0529TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1046741706MEDICAIDTEXAS
2G28466MEDICARE UPINTEXAS
38349B9MEDICARE ID-TYPE UNSPECIFIEDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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