MEDICARE: PATRICIA GHALY CPM, LM

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	176B00000X	Midwife	99199	TX

General Provider Information

NPI Number	:	1548686694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA GHALY CPM, LM

Provider Business Mailing Address
First Line	:	12850 JONES RD STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4956
Country	:	US
Telephone Number	:	281-469-0093
Fax Number	:	877-479-4937

Provider Business Practice Location Address
First Line	:	12850 JONES RD STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4956
Country	:	US
Telephone Number	:	281-469-0093
Fax Number	:	877-479-4937

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

Provider Enumeration Date	:	03/13/2014
Last Update Date	:	03/13/2014

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