Individual
DR. EDWARD SHAWN MANSOUR
Active
Individual
DR. EDWARD SHAWN MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
L1125
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121037
SUPERIOR
TX
05
—
149831302
—
TX
01
—
8J0324
BLUE CROSS
TX
01
—
P00036032
RAILROAD MEDICARE
TX
Enumeration date
06/21/2006
Last updated
11/20/2014
Update your record
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