Provider Demographics
NPI:1417243114
Name:MOSS, JASON EGLIN (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:EGLIN
Last Name:MOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ONE BAYLOR PLAZA
Mailing Address - Street 2:BCMC-286A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-798-4661
Mailing Address - Fax:713-798-5838
Practice Address - Street 1:ONE BAYLOR PLAZA
Practice Address - Street 2:BCMC-286A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-798-4661
Practice Address - Fax:713-798-5838
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0071118207ZP0102X
TXN9610207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology