Healthcare Provider Details

I. General information

NPI: 1083396808
Provider Name (Legal Business Name): ANNA K CISSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17200 STATE HIGHWAY 249 STE 150
HOUSTON TX
77064-1319
US

IV. Provider business mailing address

17200 STATE HIGHWAY 249 STE 150
HOUSTON TX
77064-1319
US

V. Phone/Fax

Practice location:
  • Phone: 281-664-6900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: