Provider Demographics
NPI:1386458537
Name:MOORE FAMILY CARE & WELLNESS LLC
Entity type:Organization
Organization Name:MOORE FAMILY CARE & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEHNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-308-8008
Mailing Address - Street 1:2990 SE 19TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-9660
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2990 SE 19TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-9660
Practice Address - Country:US
Practice Address - Phone:405-308-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty