Provider Demographics
NPI:1841478773
Name:JENNIFER L. BISSETT, PH.D., PC
Entity type:Organization
Organization Name:JENNIFER L. BISSETT, PH.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BISSETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-412-8299
Mailing Address - Street 1:18333 EGRET BAY BLVD STE 585
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18333 EGRET BAY BLVD STE 585
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3348
Practice Address - Country:US
Practice Address - Phone:281-335-3941
Practice Address - Fax:281-335-3942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32445103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty