Provider Demographics
NPI:1083360259
Name:BAHJA, ANISA (NP)
Entity type:Individual
Prefix:
First Name:ANISA
Middle Name:
Last Name:BAHJA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11017 SHERWOOD GRV
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2866
Mailing Address - Country:US
Mailing Address - Phone:832-421-6013
Mailing Address - Fax:
Practice Address - Street 1:9740 BARKER CYPRESS RD STE 108
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1974
Practice Address - Country:US
Practice Address - Phone:281-944-8013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-26
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1048499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMB7070650OtherDEA