Provider Demographics
NPI:1255684742
Name:OSSAI, FLORETTA J
Entity Type:Individual
Prefix:MRS
First Name:FLORETTA
Middle Name:J
Last Name:OSSAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10709 N MACARTHUR BLVD
Mailing Address - Street 2:APT 132
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-5219
Mailing Address - Country:US
Mailing Address - Phone:469-328-4336
Mailing Address - Fax:
Practice Address - Street 1:10709 N MACARTHUR BLVD
Practice Address - Street 2:APT 132
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-5219
Practice Address - Country:US
Practice Address - Phone:469-328-4336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-21
Last Update Date:2012-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator