Provider Demographics
NPI:1073265286
Name:OBASUYI, CATHERINE T (MED)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:T
Last Name:OBASUYI
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:ADDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:1506 BRAZOS GATE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6116
Mailing Address - Country:US
Mailing Address - Phone:512-560-7064
Mailing Address - Fax:
Practice Address - Street 1:6666 HARWIN DR STE 460
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2275
Practice Address - Country:US
Practice Address - Phone:832-538-0265
Practice Address - Fax:832-200-9386
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10919101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional