MEDICARE: MRS. IDA ALYSSA LEIGH OGLES FNP-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	363LF0000X	Family Nurse Practitioner	AP138900	TX

General Provider Information

NPI Number	:	1730664905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. IDA ALYSSA LEIGH OGLES FNP-C

Provider Business Mailing Address
First Line	:	7403 HOLLY COURT EST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-3570
Country	:	US
Telephone Number	:	409-659-6042
Fax Number	:

Provider Business Practice Location Address
First Line	:	5115 FANNIN ST STE 950
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5805
Country	:	US
Telephone Number	:	713-493-7700
Fax Number	:	281-971-4065

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

Provider Enumeration Date	:	10/03/2018
Last Update Date	:	01/23/2026

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