Provider Demographics
NPI:1134631690
Name:MOYE, GENECA KIMORIE (LICENSED VOCATIONAL)
Entity type:Individual
Prefix:MS
First Name:GENECA
Middle Name:KIMORIE
Last Name:MOYE
Suffix:
Gender:F
Credentials:LICENSED VOCATIONAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 S CHERRY ST
Mailing Address - Street 2:2701
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375
Mailing Address - Country:US
Mailing Address - Phone:409-225-7440
Mailing Address - Fax:
Practice Address - Street 1:335 EDGETON CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-2101
Practice Address - Country:US
Practice Address - Phone:409-225-7440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX325368164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX325368OtherNURSING LICENSE