MEDICARE: IVONA KOZUL FNP-C

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	723195	TX

General Provider Information

NPI Number	:	1710241120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVONA KOZUL FNP-C

Provider Business Mailing Address
First Line	:	6624 FANNIN ST STE 2380
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2308
Country	:	US
Telephone Number	:	713-790-1790
Fax Number	:

Provider Business Practice Location Address
First Line	:	6624 FANNIN ST STE 2380
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2308
Country	:	US
Telephone Number	:	713-790-1790
Fax Number	:

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

Provider Enumeration Date	:	06/29/2012
Last Update Date	:	03/03/2025

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Directions to “ IVONA KOZUL FNP-C” Practice Location

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