Individual
LEBAONE LLULU MOGOTSAKGOTLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
2020 BENTWORTH DR APT 440, HOUSTON, TX 77077-6220
(713) 562-8305
Mailing address
2020 BENTWORTH DR APT 440, HOUSTON, TX 77077-6220
(713) 562-8305
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP123544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
327062101
—
TX
Enumeration date
06/11/2013
Last updated
09/28/2016
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