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Fantasia Moore
NPI 1558218107 · on the registry since 2026
Practice
- Address
- 2609 Carrington Ln
Grand Prairie, TX 75052 - Phone
- (469) 264-1626
Registry record
- Primary taxonomy
- 342000000X
342000000X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-03-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas