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General NPI Number Information
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NPI Number | 1154535193
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Entity Type | Organization
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Legal Business Name | KATHLEEN MOSBY
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 6021 BRETSHIRE DR
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City | HOUSTON
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State | TX
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Zip | 77016-3211
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Country | US
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Telephone | 713-635-3700
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Fax | 281-446-3392
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Provider Business Mailing Address
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Address Line | PO BOX 11189
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City | HOUSTON
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State | TX
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Zip | 77293-1189
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Country | US
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Telephone | 713-259-6470
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Fax | 281-446-3392
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. KATHLEEN MOSBY
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Credential |
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Telephone | 713-259-6470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 100075
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License Number State | TX
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