Active NPI
Susan Moons Moore, PHD
- Clinical Psychologist
- Austin, TX
National Provider Identifier
1063446169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 31396
- Practice address
- 7010 W Highway 71
Suite 340-143
Austin, TX 78735-8300 - Phone
- (512) 301-0920
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 31396 | TX | Primary |
Addresses
Primary practice location
7010 W Highway 71
Suite 340-143
Austin, TX 78735-8300
Mailing address
2200 Bergquist
Suite 1
Lackland Afb, TX 78236-5300
Phone (210) 292-6707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31396 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063446169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 BERGQUIST",
"address_2": "SUITE 1",
"city": "LACKLAND AFB",
"state": "TX",
"postal_code": "782365300",
"telephone_number": "210-292-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7010 W HIGHWAY 71",
"address_2": "SUITE 340-143",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787358300",
"telephone_number": "512-301-0920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "SUSAN",
"middle_name": "MOONS",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "31396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.