Provider Demographics
NPI:1134903040
Name:JOE, KRISTIN ELISE (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ELISE
Last Name:JOE
Suffix:
Gender:
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12307 PIPING ROCK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5919
Mailing Address - Country:US
Mailing Address - Phone:281-755-4971
Mailing Address - Fax:
Practice Address - Street 1:8500 N MOPAC EXPY STE 901
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8348
Practice Address - Country:US
Practice Address - Phone:512-843-5781
Practice Address - Fax:877-775-0322
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88827133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered