MEDICARE: LINDA MOGHALU NP

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	363LF0000X	Family Nurse Practitioner	AP125365	TX

General Provider Information

NPI Number	:	1558787440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA MOGHALU NP

Provider Business Mailing Address
First Line	:	1107 TYDEMAN CT
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-7431
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15010 MEMORIAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-4302
Country	:	US
Telephone Number	:	281-368-1600
Fax Number	:

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

Provider Enumeration Date	:	03/15/2014
Last Update Date	:	05/30/2024

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