Healthcare Provider Details

I. General information

NPI: 1811448038
Provider Name (Legal Business Name): UNGELICA ROSE MOSES DNP, WHNP-BC, RNC-OB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 N MACARTHUR BLVD STE 100
IRVING TX
75039-2471
US

IV. Provider business mailing address

6750 N MACARTHUR BLVD STE 100
IRVING TX
75039-2471
US

V. Phone/Fax

Practice location:
  • Phone: 469-455-8990
  • Fax: 469-455-8991
Mailing address:
  • Phone: 469-455-8990
  • Fax: 469-455-8991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1043961
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: