MEDICARE: JONI LYNNE PHEIGARU RN, MSN, PNNP

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	503317	TX

General Provider Information

NPI Number	:	1205824596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONI LYNNE PHEIGARU RN, MSN, PNNP

Provider Business Mailing Address
First Line	:	929 GESSNER RD.
Second Line	:	SUITE 2225
City	:	HOUSTON
State	:	TX
Zip	:	77024-2501
Country	:	US
Telephone Number	:	713-365-2900
Fax Number	:	713-984-6525

Provider Business Practice Location Address
First Line	:	929 GESSNER RD.
Second Line	:	SUITE 2225
City	:	HOUSTON
State	:	TX
Zip	:	77024-2501
Country	:	US
Telephone Number	:	713-365-2900
Fax Number	:	713-984-9525

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	01/22/2009

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