MEDICARE: MRS. CHIMI LINDA FOSSO M.D.

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	207R00000X	Internal Medicine Physician	R7452	TX
2	207RH0003X	Hematology & Oncology Physician	R7452	TX

General Provider Information

NPI Number	:	1285029579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHIMI LINDA FOSSO M.D.

Provider Business Mailing Address
First Line	:	16537 SOUTHWEST FREEWAY
Second Line	:	MOB 4, SUITE 325
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7238
Country	:	US
Telephone Number	:	281-276-5200
Fax Number	:	281-276-5201

Provider Business Practice Location Address
First Line	:	16537 SOUTHWEST FREEWAY
Second Line	:	MOB 4, SUITE 325
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7238
Country	:	US
Telephone Number	:	281-276-5200
Fax Number	:	281-276-5201

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

Provider Enumeration Date	:	04/02/2015
Last Update Date	:	11/07/2024

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