Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shane Moore

Individual provider Family Nurse Practitioner · NPI 1417426529

Shane Moore is a Nurse Practitioner in Waco, Texas. Qualified in 2018, 8 years ago. Practices with Legacy Urgent Care PA, a 158-clinician group and works from 2 locations. Licensed in Texas.

Years since qualifying
8
Licensed in
TX
In the registry since
2018
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Practice location Address checks out

7030 New Sanger Ave Ste 204
Waco, TX 76712-4074
Phone: (254) 245-9175
Fax: (254) 213-7771
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2304 Marketplace Dr, Waco, TX 76711-2467 — (254) 202-7300

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP139172 (TX)

Record details

NPI number1417426529
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 19, 2018
Last updated in NPPESOctober 14, 2020
Certification dateOctober 14, 2020
Mailing addressPo Box 11538, Killeen, TX 76547-1538

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Legacy Urgent Care Pa — 158 clinicians
Accepts Medicare assignment Not indicated

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