MEDICARE: MRS. CHADNEZZAR MORGAN RN

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	163W00000X	Registered Nurse	909957	TX

General Provider Information

NPI Number	:	1619541570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHADNEZZAR MORGAN RN

Provider Business Mailing Address
First Line	:	PO BOX 73363
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77273-3363
Country	:	US
Telephone Number	:	832-529-7125
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 N SAM HOUSTON PKWY E STE 450
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-4090
Country	:	US
Telephone Number	:	832-529-7125
Fax Number	:

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

Provider Enumeration Date	:	05/16/2021
Last Update Date	:	05/16/2021

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