MEDICARE: MRS. MAUREEN PATRICIA LALL M.S.N., R.N., F.N.P.

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	659528	TX

General Provider Information

NPI Number	:	1891809638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAUREEN PATRICIA LALL M.S.N., R.N., F.N.P.

Provider Business Mailing Address
First Line	:	5227 IVYSTONE CT
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4105
Country	:	US
Telephone Number	:	281-265-6667
Fax Number	:

Provider Business Practice Location Address
First Line	:	4126 SOUTHWEST FWY
Second Line	:	SUITE 440
City	:	HOUSTON
State	:	TX
Zip	:	77027-7310
Country	:	US
Telephone Number	:	713-621-5511
Fax Number	:	713-621-5588

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	07/08/2007

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