# ABDUL R MOOSA MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** La Porte Family Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972790228
- **Authorized official:** DR. ABDUL R MOOSA M.D. (OWNER/PHYSICIAN)
- **Authorized official phone:** (281) 470-4740

## Contact information

- **Practice address:** 401 W FAIRMONT PKWY, SUITE \# D, LA PORTE, TX 77571-6307
- **Practice address phone:** (281) 470-4740
- **Practice address fax:** (281) 470-4733
- **Mailing address:** 401 W FAIRMONT PKWY, SUITE \# D, LA PORTE, TX 77571-6307
- **Mailing address phone:** (281) 470-4740
- **Mailing address fax:** (281) 470-4733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | J3015 | TX | Yes |

## Other

- **Enumeration date:** 10/01/2007
- **Last updated:** 07/24/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 126988802 | — | TX |