Healthcare Provider Details

I. General information

NPI: 1548066731
Provider Name (Legal Business Name): DAVID OBASI PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 11/02/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22019 AVONGLEN LN
SPRING TX
77389-4842
US

IV. Provider business mailing address

22019 AVONGLEN LN
SPRING TX
77389-4842
US

V. Phone/Fax

Practice location:
  • Phone: 954-995-6663
  • Fax:
Mailing address:
  • Phone: 954-995-6663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberRN9524167
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: