Basic Information
| Provider Information | |||||||||
| NPI: | 1881159929 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOSEBEE | ||||||||
| FirstName: | NATHAN | ||||||||
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| Credential: | CAA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3711 WHEELER ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770045533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8173041490 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 BAYLOR PLZ | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770303498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137987356 | ||||||||
| FaxNumber: | 7137986374 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2019 | ||||||||
| LastUpdateDate: | 06/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367H00000X | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Anesthesiologist Assistant | 367H00000X | 28513409 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Anesthesiologist Assistant |
No ID Information.