Provider Demographics
NPI:1235487570
Name:MOSS, ALBERT D C (PT)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:D C
Last Name:MOSS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6301 HARRIS PKWY
Mailing Address - Street 2:STE 150
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4249
Mailing Address - Country:US
Mailing Address - Phone:817-433-1450
Mailing Address - Fax:817-433-1451
Practice Address - Street 1:6301 HARRIS PKWY
Practice Address - Street 2:STE 150
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4249
Practice Address - Country:US
Practice Address - Phone:817-433-1450
Practice Address - Fax:817-433-1451
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC6824225100000X
TX1241520225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist