Provider Demographics
NPI:1063850659
Name:SASSIE, JENNA BREANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:BREANNE
Last Name:SASSIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1315 ST JOSEPH PKWY STE 1818
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8238
Mailing Address - Country:US
Mailing Address - Phone:713-654-8128
Mailing Address - Fax:713-654-7426
Practice Address - Street 1:5373 W ALABAMA ST STE 206
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5923
Practice Address - Country:US
Practice Address - Phone:713-975-8353
Practice Address - Fax:713-975-1143
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10046807390200000X
TXR2730207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program