=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952732711
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KATHLEEN MOSBY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2013
-----------------------------------------------------
Last Update Date | 12/04/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7634 CABOT ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77016-3918
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-491-9582
-----------------------------------------------------
Fax | 281-492-0980
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 62262
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77205-2262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-933-4862
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. KATHLEEN MOSBY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-635-3700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | 134383
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------