Provider Demographics
NPI:1447257530
Name:MOORE, KRISTIN A (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:A
Last Name:MOORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7707 FANNIN ST
Mailing Address - Street 2:STE 195
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1989
Mailing Address - Country:US
Mailing Address - Phone:713-797-0045
Mailing Address - Fax:713-797-1821
Practice Address - Street 1:7707 FANNIN ST
Practice Address - Street 2:STE 195
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1989
Practice Address - Country:US
Practice Address - Phone:713-797-0045
Practice Address - Fax:713-797-1821
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF6969207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C19554Medicare UPIN
TX876209Medicare PIN