Provider Demographics
NPI:1629165253
Name:MORALES, ROSALINDA (PHD, FNP)
Entity Type:Individual
Prefix:DR
First Name:ROSALINDA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:PHD, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 FANNIN ST
Mailing Address - Street 2:SUITE 370
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3000
Mailing Address - Country:US
Mailing Address - Phone:713-704-6806
Mailing Address - Fax:713-704-6909
Practice Address - Street 1:6410 FANNIN ST
Practice Address - Street 2:SUITE 370
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3000
Practice Address - Country:US
Practice Address - Phone:713-704-6806
Practice Address - Fax:713-704-6909
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX233027363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018907802Medicaid
TX018907804Medicaid
TX87N269Medicare ID - Type Unspecified
TX8K6259Medicare PIN
TX018907802Medicaid