MEDICARE: NATHANAEL ADMAS KASSA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver	22934701	TX

General Provider Information

NPI Number	:	1376350298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHANAEL ADMAS KASSA

Provider Business Mailing Address
First Line	:	6517 REAMER ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-6809
Country	:	US
Telephone Number	:	346-932-2821
Fax Number	:

Provider Business Practice Location Address
First Line	:	6517 REAMER ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-6809
Country	:	US
Telephone Number	:	346-932-2821
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2024
Last Update Date	:	12/13/2024

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Directions to “ NATHANAEL ADMAS KASSA ” Practice Location

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