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1679261911

NPI Code Detail

MEDICARE: KRISTIN LARSEN MOORE MD

MEDICARE: KRISTIN LARSEN MOORE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	764827	TX
2	207QS1201X	Sleep Medicine (Family Medicine) Physician	764827	TX
3	207QB0002X	Obesity Medicine (Family Medicine) Physician	764827	TX
4	207QG0300X	Geriatric Medicine (Family Medicine) Physician	764827	TX
5	207QA0401X	Addiction Medicine (Family Medicine) Physician	764827	TX
6	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	764827	TX
7	207Q00000X	Family Medicine Physician	764827	TX
8	207QS0010X	Sports Medicine (Family Medicine) Physician	764827	TX
9	207QA0000X	Adolescent Medicine (Family Medicine) Physician	764827	TX

General Provider Information

NPI Number	:	1679261911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN LARSEN MOORE MD

Provider Business Mailing Address
First Line	:	1745 PEACHTREE ST NE STE U
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2479
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 RED RIVER ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78712-1845
Country	:	US
Telephone Number	:	512-495-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2023
Last Update Date	:	06/16/2026

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Directions to “ KRISTIN LARSEN MOORE MD” Practice Location

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