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Deactivated NPI 1770588048 Deactivated / Inactive NPI Male Practitioner

Alfred Sam Moore , PA

Physician Assistant • Marlin, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Alfred Moore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 14, 2005
NPI Deactivation Date February 13, 2017
Total Practice Duration ~12 Years of Practice (2005 – 2017)

Professional Overview & Biography Verified Profile Summary

Alfred Moore, PA was a registered Physician Assistant practicing in Marlin, TX. Throughout an active medical career spanning 12 years, Alfred Moore provided care at the practice location at 307 LIVE OAK ST until profile deactivation on 2017-02-13.

Practice Location & Contact Primary Location

Practice Address

307 Live Oak St

Marlin, TX 766612365

Telephone 2548033561
Fax 2548836066
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Marlin, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.9 Yrs
Regional Practice Density
2 Specialists

Practicing in Marlin, TX (11140 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License TX PA00023

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

13 Associated Practitioners
Britni Burks , APRN

Nurse Practitioner - Primary Care

NPI 1134854003

Advanced Practice Registered Nurse

NPI 1275537664

Doctor of Philosophy (Ph.D.)

Charlotte Widick , ENP

Nurse Practitioner - Acute Care

NPI 1376581751
NPI 1467456962

Doctor of Medicine (M.D.)

Jeremy Reynolds , PA-C

Physician Assistant

NPI 1518933852

Physician Assistant (Certified)

NPI 1538163027

Doctor of Chiropractic

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 13, 2017

Record deactivated on February 13, 2017

NPI Profile Active August 06, 2009

NPI status registered as active in NPPES database

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Updated Practice Location August 06, 2009

Registered at 307 LIVE OAK ST, MARLIN, TX 766612365 (Tel: 2548033561)

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Updated Business Mailing Address August 06, 2009

Registered at PO BOX 60, MARLIN, TX 766610060 (Tel: 2548033561)

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Provider Name / Credentials Updated August 06, 2009

Recorded as ALFRED MOORE, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 06, 2009

Physician Assistant (License #PA00023 in TX)

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Initial NPI Registration & Enumeration June 14, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770588048
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 14, 2005
Last Update: August 06, 2009
Deactivation Date: February 13, 2017

Mailing Address

Po Box 60

Marlin, TX 766610060

Phone: 2548033561

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.