Provider Demographics
NPI:1043701113
Name:BITTNER, DESIREE (FNP)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:BITTNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16145 HIGHWAY 105 W STE 600
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-6069
Mailing Address - Country:US
Mailing Address - Phone:936-463-8104
Mailing Address - Fax:936-242-6881
Practice Address - Street 1:20207 CHASEWOOD PARK DR STE 305
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1442
Practice Address - Country:US
Practice Address - Phone:281-290-0222
Practice Address - Fax:281-290-0233
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137605363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily