Provider Demographics
NPI:1184382582
Name:OSAGHAE, SONNY IRIAGBONSE (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:SONNY
Middle Name:IRIAGBONSE
Last Name:OSAGHAE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11526 LANTANA REACH DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1480
Mailing Address - Country:US
Mailing Address - Phone:832-275-2655
Mailing Address - Fax:
Practice Address - Street 1:11526 LANTANA REACH DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-1480
Practice Address - Country:US
Practice Address - Phone:832-868-7332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1058336363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health