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General NPI Number Information
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NPI Number | 1821712290
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Entity Type | Individual
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Provider Name | SUSAN MSOMA NP
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Gender | Female
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 1125 CYPRESS STATION DR STE B-1
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City | HOUSTON
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State | TX
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Zip | 77090-3055
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Country | US
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Telephone | 281-586-7880
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Fax | 281-580-5061
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Provider Business Mailing Address
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Address Line | 8850 LONG POINT RD APT 7215
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City | HOUSTON
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State | TX
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Zip | 77055-3080
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Country | US
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Telephone | 615-668-9557
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Fax | 281-580-5061
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1018924
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License Number State | TX
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