Provider Demographics
NPI:1881697183
Name:MOORE, BUFFORD D (MD)
Entity type:Individual
Prefix:DR
First Name:BUFFORD
Middle Name:D
Last Name:MOORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850001
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0001
Mailing Address - Country:US
Mailing Address - Phone:813-536-7277
Mailing Address - Fax:855-830-1722
Practice Address - Street 1:11006 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-4416
Practice Address - Country:US
Practice Address - Phone:281-470-2100
Practice Address - Fax:281-867-8219
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0651207Q00000X, 2082S0105X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2319524OtherBLUELINK
TX5539579OtherAETNA PPO
TX80722BOtherBCBS
TX5998630001OtherCIGNA HMO
TX69372OtherAMERIGROUP
TX8F9246OtherMEDICARE PTAN
TX037484501Medicaid
TX079838101OtherTEXAS PROVIDER IDENTIFIER
TX2093857OtherAETNA HMO
TX240006605OtherRAILROAD
TX079838101OtherTEXAS PROVIDER IDENTIFIER
TX69372OtherAMERIGROUP