MEDICARE: DR. CHRISTOPHER BARRET MOEDER 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	208600000X	Surgery Physician	S0947	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8LP415	OTHER	TX	BCBC

General Provider Information

NPI Number	:	1265843791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER BARRET MOEDER MD

Provider Business Mailing Address
First Line	:	PO BOX 2078
Second Line	:
City	:	DECATUR
State	:	TX
Zip	:	76234-6156
Country	:	US
Telephone Number	:	940-539-0707
Fax Number	:	940-228-0165

Provider Business Practice Location Address
First Line	:	2000 BEN MERRITT DR STE B
Second Line	:
City	:	DECATUR
State	:	TX
Zip	:	76234-3848
Country	:	US
Telephone Number	:	940-539-0707
Fax Number	:	940-228-0165

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

Provider Enumeration Date	:	05/19/2014
Last Update Date	:	01/26/2023

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