Provider Demographics
NPI:1801030648
Name:MOSLEY, ANGELA N (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:N
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7737 SOUTHWEST FWY STE 800
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1820
Mailing Address - Country:US
Mailing Address - Phone:713-778-9955
Mailing Address - Fax:713-778-9969
Practice Address - Street 1:7737 SOUTHWEST FWY STE 800
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1820
Practice Address - Country:US
Practice Address - Phone:713-778-9955
Practice Address - Fax:713-778-9969
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXN3194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMO165070OtherDPS
TXN3194OtherMEDICAL LICENSE
TXN3194OtherMEDICAL LICENSE
TXTXB134686Medicare PIN