Provider Demographics
NPI:1386894921
Name:MOSES, RICK P (LMFT)
Entity type:Individual
Prefix:MR
First Name:RICK
Middle Name:P
Last Name:MOSES
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32092 FM 803
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-4211
Mailing Address - Country:US
Mailing Address - Phone:956-434-1351
Mailing Address - Fax:866-844-2096
Practice Address - Street 1:4430 E 14TH ST
Practice Address - Street 2:UNIT E-3
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3363
Practice Address - Country:US
Practice Address - Phone:956-434-1351
Practice Address - Fax:866-844-2096
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4663106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTPI 1988883-01Medicaid