MEDICARE: DR. ANGELA N MOSLEY 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	N3194	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MO165070	OTHER	TX	DPS
2	N3194	OTHER	TX	MEDICAL LICENSE

General Provider Information

NPI Number	:	1801030648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELA N MOSLEY M.D.

Provider Business Mailing Address
First Line	:	7737 SOUTHWEST FWY STE 800
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1820
Country	:	US
Telephone Number	:	713-778-9955
Fax Number	:	713-778-9969

Provider Business Practice Location Address
First Line	:	7737 SOUTHWEST FWY STE 800
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1820
Country	:	US
Telephone Number	:	713-778-9955
Fax Number	:	713-778-9969

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

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	03/07/2023

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