Healthcare Provider Details

I. General information

NPI: 1528981834
Provider Name (Legal Business Name): SAMIYAH HOSSAIN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 BRIARCREST DR STE 400
BRYAN TX
77802-2766
US

IV. Provider business mailing address

18026 BARTON RIDGE LN
RICHMOND TX
77407-2076
US

V. Phone/Fax

Practice location:
  • Phone: 979-436-9557
  • Fax:
Mailing address:
  • Phone: 713-474-6753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number114057
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: