Jason Moore, LCDC

NPI 1811839111 · on the registry since 2026 · sole proprietor

Practice

Address: 3110 H G Mosley Pkwy Ste 104
Longview, TX 75605
Phone: (903) 758-2471
Fax: (903) 234-1639
Organisation at this address: Sabine Valley Regional Mhmr Center
Renal Treatment Centers-Southeast, Lp.
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Licence states on file: TX
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-04-07

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