Healthcare Provider Details

I. General information

NPI: 1710538731
Provider Name (Legal Business Name): FATEMA BILLAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 01/17/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17070 RED OAK DR STE 202
HOUSTON TX
77090-2615
US

IV. Provider business mailing address

17070 RED OAK DR STE 202
HOUSTON TX
77090-2615
US

V. Phone/Fax

Practice location:
  • Phone: 281-440-9500
  • Fax:
Mailing address:
  • Phone: 281-440-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number888859
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP145050
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: