Provider Demographics
NPI:1821743865
Name:MENSAH, MARTIN NONE (APN)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:NONE
Last Name:MENSAH
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2433
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77410-2433
Mailing Address - Country:US
Mailing Address - Phone:832-938-9353
Mailing Address - Fax:
Practice Address - Street 1:19206 JUERGEN RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-5758
Practice Address - Country:US
Practice Address - Phone:505-445-4076
Practice Address - Fax:210-444-2171
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073624363LP0808X
TX555398363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health