Healthcare Provider Details

I. General information

NPI: 1023834827
Provider Name (Legal Business Name): ALYSSA A FASSIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 ABRAMS RD STE 112
DALLAS TX
75214-2000
US

IV. Provider business mailing address

7500 SAN FELIPE ST STE 990
HOUSTON TX
77063-1708
US

V. Phone/Fax

Practice location:
  • Phone: 469-906-6372
  • Fax: 469-754-0920
Mailing address:
  • Phone: 281-826-3382
  • Fax: 425-491-7683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7778
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: