Individual
DR. EDWARD SHAWN MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9201 PINECROFT DR, SUITE 295, SHENANDOAH, TX 77380-3222
(281) 746-3070
(281) 970-5118
Mailing address
PO BOX 9969, THE WOODLANDS, TX 77387-6969
(281) 746-3070
(281) 970-5118
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
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