MEDICARE: MR. DAVID OBASI APRN, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1117000	TX

General Provider Information

NPI Number	:	1548066731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID OBASI APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	22019 AVONGLEN LN
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-4842
Country	:	US
Telephone Number	:	954-995-6663
Fax Number	:

Provider Business Practice Location Address
First Line	:	22019 AVONGLEN LN
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-4842
Country	:	US
Telephone Number	:	954-995-6663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2025
Last Update Date	:	01/22/2026

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