IndividualActive
Agatha Moore
NPI 1790303477 · Licensed Vocational Nurse · Tyler, TX
Provider details
- NPI number
- 1790303477
- Entity type
- Individual
- Primary specialty
- Licensed Vocational NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 12566185 (TX)
Specialties & taxonomies
Nursing Service Providers
Practice location
9846 Hwy 31 E
Tyler, TX 75705-2329
Phone: (903) 592-8001
Approximate (ZIP-level) locationGet directions
Mailing address
9846 Hwy 31 E
Tyler, TX 75705-2329
Registry dates
- Enumerated
- 2020-07-09
- Last updated
- 2020-07-09
- Certified
- 2020-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.