WYLIE MASTERSON MOODY
NPI 1740920529
Dermatology in Houston, TX

Q: What is Wylie Moody's NPI number?

The NPI number for Wylie Moody is 1740920529. It was assigned to this individual provider in the NPPES registry on March 30, 2022.

Q: What is Wylie Moody's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Wylie Moody was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 30, 2022PECOS EnrolledAccepts Medicare Assignment

12141 RICHMOND AVE, HOUSTON, TX 77082(281) 558-3444 Get Directions Write a Review

NPPES record last updated: March 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Wylie Masterson Moody NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WYLIE MASTERSON MOODY (NPI 1740920529) is an individual dermatology provider in Houston, Texas, licensed in Texas (V8697) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical School At Houston (2022).

NPPES Registry Identity

NPI1740920529

Entity TypeIndividualFemale

Primary Taxonomy207N00000X

Provider Legal NameWYLIE MASTERSON MOODY

Location Address12141 RICHMOND AVEHouston, TX 77082-2408

Mailing Address6404 Nursery Dr Ste 201Victoria, TX 77904-1688

Phone(281) 558-3444

Sole ProprietorNo

Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 2022

Enumeration DateMarch 30, 2022

Last NPPES UpdateMarch 12, 2026

NPPES CertifiedMarch 12, 2026

✔ NPI 1740920529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in TX · V8697

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

12141 RICHMOND AVE, Houston, TX 77082

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Wylie Masterson Moody is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668859968

PECOS Enrollment IDI20260520003980

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77082 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.40 typical visit price

range $58.24 – $176.98

Typical copayment $22.60 (range $14.56 – $44.24)

Most-billed visit code 99203

Established Patient

$72.62 typical visit price

range $18.60 – $143.93

Typical copayment $18.15 (range $4.65 – $35.98)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ROMEO PENAFLOR JR.

Nurse Practitioner (Family)