Healthcare Provider Details

I. General information

NPI: 1730983768
Provider Name (Legal Business Name): ELIZABETH SABINE WITT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6411 FANNIN ST
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

6410 FANNIN ST STE 950
HOUSTON TX
77030-5204
US

V. Phone/Fax

Practice location:
  • Phone: 713-704-5437
  • Fax:
Mailing address:
  • Phone: 832-325-7234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1179941
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1179941
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: