Provider Demographics
NPI:1972169332
Name:OSAGHAE, MERCY (PMHNP)
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:
Last Name:OSAGHAE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26622 COOK FIELD RD STE 700
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1138
Mailing Address - Country:US
Mailing Address - Phone:281-917-0667
Mailing Address - Fax:
Practice Address - Street 1:26622 COOK FIELD RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2123
Practice Address - Country:US
Practice Address - Phone:281-917-0667
Practice Address - Fax:832-743-1997
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-11
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29959363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP141351OtherLICENSE NUMBER