# MANTIS MEDICAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558165803
- **Authorized official:** TANISHA MANGON (OWNER)
- **Authorized official phone:** (832) 334-8427

## Contact information

- **Practice address:** 14090 SOUTHWEST FWY STE 300, SUGAR LAND, TX 77478-3679
- **Practice address phone:** (281) 524-8902
- **Practice address fax:** (281) 805-1386
- **Mailing address:** 12202 QUIET MEADOW CT, MEADOWS PLACE, TX 77477-2258

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/03/2025
- **Last updated:** 07/11/2025