MEDICARE: NGOZI GLADYS KALU AGNP-C

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	363LA2200X	Adult Health Nurse Practitioner	1032505	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1032505	TX

General Provider Information

NPI Number	:	1437342250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGOZI GLADYS KALU AGNP-C

Provider Business Mailing Address
First Line	:	4411 AVERSA DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-3809
Country	:	US
Telephone Number	:	832-607-9802
Fax Number	:

Provider Business Practice Location Address
First Line	:	25140 KINGSLAND BLVD STE 200
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-8472
Country	:	US
Telephone Number	:	832-607-9802
Fax Number	:

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

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	05/23/2025

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