Individual ProviderJessica Joy MooreSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1611 Headway Cir Bldg 2, Austin, TX 78754-5165(512) 478-2581PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Joy Moore does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1215070230Provider TypeIndividualFull NameMoore, Jessica JoyGenderFemaleSole ProprietorNoEnumeration Date2/15/2007Last Updated5/6/2008Contact InformationPractice LocationPractice Address1611 Headway Cir Bldg 2, Austin, TX 78754-5165Phone(512) 478-2581Fax(512) 476-1638Mailing LocationMailing Address1611 Headway Cir Bldg 2, Austin, TX 78754-5165Phone(512) 478-2581Fax(512) 476-1638Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense102612TexasProvider IdentifiersIDDescriptionIssuerID021286201DescriptionMedicaidIssuerUnlistedTexasID126129901DescriptionMedicaidIssuerUnlistedTexasID87765TDescriptionOtherIssuerBLUE CROSSTexas