MEDICARE: NSUELA ROSY MUKANA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	N5893	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	N5893	OTHER	TX	TEXAS MEDICAL BOARD LICENSE

General Provider Information

NPI Number	:	1427284017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NSUELA ROSY MUKANA M.D.

Provider Business Mailing Address
First Line	:	3208 BROADWAY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-2321
Country	:	US
Telephone Number	:	713-928-2774
Fax Number	:	713-928-2781

Provider Business Practice Location Address
First Line	:	3208 BROADWAY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-2321
Country	:	US
Telephone Number	:	713-928-2774
Fax Number	:	713-928-2781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2009
Last Update Date	:	05/15/2026

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