Provider Demographics
NPI:1538789441
Name:BONSU, NANA-YAW OWUSUACHIAW
Entity type:Individual
Prefix:
First Name:NANA-YAW
Middle Name:OWUSUACHIAW
Last Name:BONSU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6670 BERTNER AVE # R2-216
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2602
Mailing Address - Country:US
Mailing Address - Phone:626-506-1678
Mailing Address - Fax:
Practice Address - Street 1:6670 BERTNER AVE # R2-216
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2602
Practice Address - Country:US
Practice Address - Phone:713-441-4934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program