Provider Demographics
NPI:1285924118
Name:MANSOUR, ASHTON S (MD)
Entity type:Individual
Prefix:DR
First Name:ASHTON
Middle Name:S
Last Name:MANSOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6400 FANNIN ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:713-486-7500
Mailing Address - Fax:713-512-2234
Practice Address - Street 1:6400 FANNIN ST STE 2250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1536
Practice Address - Country:US
Practice Address - Phone:713-486-7500
Practice Address - Fax:713-512-2234
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXR1412207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX373620902Medicaid