Basic Information
| Provider Information | |||||||||
| NPI: | 1346297702 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORA | ||||||||
| FirstName: | OLGA | ||||||||
| MiddleName: | Y | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 WEST LOOP SOUTH | ||||||||
| Address2: | STE 400B | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814441738 | ||||||||
| FaxNumber: | 2814443084 | ||||||||
| Practice Location | |||||||||
| Address1: | 3450 FM 1960 W | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814441738 | ||||||||
| FaxNumber: | 2814443084 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2006 | ||||||||
| LastUpdateDate: | 09/14/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 439453 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.