Provider Demographics
NPI:1124989058
Name:OSAZUWA, MABEL
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:OSAZUWA
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 1:18927 BARKER VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2007
Mailing Address - Country:US
Mailing Address - Phone:832-231-2130
Mailing Address - Fax:
Practice Address - Street 1:8118 FRY RD STE 701
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7850
Practice Address - Country:US
Practice Address - Phone:281-815-5033
Practice Address - Fax:281-815-8537
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18312106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician