Individual provider Active NPI

William Kissam

  • Addiction (Substance Use Disorder) Counselor
  • Houston, TX
National Provider Identifier
1356641070
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
4216 Issued in TX
Practice address
11510 Homestead Rd
Houston, TX 77016-1237
Phone
(281) 449-3233
Fax
(281) 449-3230
NPI assigned
Oct 28, 2010
Last updated
Oct 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4216 TX Primary

Addresses

Primary practice location

11510 Homestead Rd
Houston, TX 77016-1237

Mailing address

11510 Homestead Rd
Houston, TX 77016-1237
Phone (281) 449-3233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4216TXMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1356641070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11510 HOMESTEAD RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770161237",
            "telephone_number": "281-449-3233",
            "fax_number": "281-449-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11510 HOMESTEAD RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770161237",
            "telephone_number": "281-449-3233",
            "fax_number": "281-449-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSAM",
        "first_name": "WILLIAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-28",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "4216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.