Healthcare Provider Details

I. General information

NPI: 1841169653
Provider Name (Legal Business Name): EMEM TITUS BASSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25319 INTERSTATE 45
SPRING TX
77380-3549
US

IV. Provider business mailing address

25319 INTERSTATE 45
SPRING TX
77380-3549
US

V. Phone/Fax

Practice location:
  • Phone: 832-810-0200
  • Fax: 888-682-7273
Mailing address:
  • Phone: 832-810-0200
  • Fax: 888-682-7273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1003158
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: