Individual provider · Type 1 NPI

Vivian Moultrie, MD

Student in an Organized Health Care Education/Training Program · Webster, TX

NPI number 1114865326 Active

Practice location

500 W Medical Center Blvd
Webster, TX 77598-4220

Call (512) 423-2815 Map

Mailing address

PO Box 414
Eden, GA 31307-0414

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1114865326

Vivian Moultrie, MD's National Provider Identifier is 1114865326, issued on Mar 23, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Webster, TX. The record was last updated on Mar 23, 2026.