Bissonnet Internal Medicine PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

L0158 Issued in TX

Legal business name

BISSONNET INTERNAL MEDICINE PA

Practice address

7737 Southwest Fwy
Suite 620
Houston, TX 77074-1807

Phone

(713) 484-9100

Fax

(713) 484-7558

NPI assigned

Jul 16, 2007

Organization subpart

No

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

Authorized official

Name

Obiajulu Cletus Ezenwabachili, MDNPI 1518945674

Title

Owner

Phone

(713) 484-9100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Obiajulu Cletus Ezenwabachili, M.D.

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1518945674
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1902005473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7737 SOUTHWEST FWY",
            "address_2": "SUITE 620",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741807",
            "telephone_number": "713-484-9100",
            "fax_number": "713-484-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7737 SOUTHWEST FWY",
            "address_2": "SUITE 620",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741807",
            "telephone_number": "713-484-9100",
            "fax_number": "713-484-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISSONNET INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "EZENWABACHILI",
        "authorized_official_first_name": "OBIAJULU",
        "authorized_official_middle_name": "CLETUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-484-9100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L0158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jonmenjoy Biswas, M.D.

• Internal Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.