MEDICARE: MALVIKA GOYEL

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	AP131706	TX

General Provider Information

NPI Number	:	1801341201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALVIKA GOYEL

Provider Business Mailing Address
First Line	:	2237 WAXWING DRIVE
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573
Country	:	UM
Telephone Number	:	832-629-0956
Fax Number	:

Provider Business Practice Location Address
First Line	:	985 NASA PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3039
Country	:	US
Telephone Number	:	281-218-6777
Fax Number	:	866-665-6208

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

Provider Enumeration Date	:	08/16/2016
Last Update Date	:	08/16/2016

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