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NPI Code Detail

MEDICARE: ISHA OMAR IBRAHIM

MEDICARE: ISHA OMAR IBRAHIM
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1770431488
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISHA OMAR IBRAHIM
Provider Business Mailing Address
First Line : 1910 WESTMEAD DR APT 4105
Second Line :
City : HOUSTON
State : TX
Zip : 77077-4727
Country : US
Telephone Number : 281-965-1629
Fax Number :
Provider Business Practice Location Address
First Line : 6914 BRISBANE CT
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-4923
Country : US
Telephone Number : 844-272-7223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ ISHA OMAR IBRAHIM ” Practice Location

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