Provider Demographics
NPI:1194837112
Name:MOSTERT, JACQUELINE F (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:F
Last Name:MOSTERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16902 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3573
Mailing Address - Country:US
Mailing Address - Phone:281-242-2719
Mailing Address - Fax:281-491-3299
Practice Address - Street 1:16902 SOUTHWEST FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3573
Practice Address - Country:US
Practice Address - Phone:281-242-2719
Practice Address - Fax:281-491-3299
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH8270207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF87418Medicare UPIN
TX00N30TMedicare ID - Type Unspecified