Healthcare Provider Details

I. General information

NPI: 1871071472
Provider Name (Legal Business Name): CHRISTY MOOSA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 W PIERCE ST
CARLSBAD NM
88220-3553
US

IV. Provider business mailing address

18614 N COLONY SHORE DR
CYPRESS TX
77433-2472
US

V. Phone/Fax

Practice location:
  • Phone: 575-887-4100
  • Fax: 659-235-6176
Mailing address:
  • Phone: 423-503-8435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF06182603
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: