Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | R1412 | TX |
NPI | 1285924118 |
---|---|
Provider Name | Dr. Ashton S Mansour |
First Address | Houston, TX 77030-1526 |
Second Address | Houston, TX 77030-1536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2011 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
373620902 | (05) | TX |