Individual
MISS JOSEPHINE LUSAMBA IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12337 JONES RD STE 200-12, HOUSTON, TX 77070-4893
(903) 345-4545
Mailing address
12337 JONES RD STE 200-12, HOUSTON, TX 77070-4893
(903) 345-4545
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EIN-842992016
—
TX
Enumeration date
11/25/2022
Last updated
11/25/2022
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