MEDICARE: DR. CURRISSA PRUITT ALSOBROOKS M.D.

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	207Q00000X	Family Medicine Physician	01069748A	IN
2	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	P7058	TX
3	207Q00000X	Family Medicine Physician	P7058	TX

General Provider Information

NPI Number	:	1598050148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CURRISSA PRUITT ALSOBROOKS M.D.

Provider Business Mailing Address
First Line	:	18525 W LAKE HOUSTON PKWY STE 104
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-3446
Country	:	US
Telephone Number	:	281-713-6543
Fax Number	:

Provider Business Practice Location Address
First Line	:	18525 W LAKE HOUSTON PKWY STE 104
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-3446
Country	:	US
Telephone Number	:	281-713-6543
Fax Number	:

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

Provider Enumeration Date	:	06/11/2011
Last Update Date	:	06/04/2025

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