Provider Demographics
NPI:1184137614
Name:TSOPZE, ROLAND MARTIAL (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ROLAND
Middle Name:MARTIAL
Last Name:TSOPZE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18383 PRESTON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5487
Mailing Address - Country:US
Mailing Address - Phone:469-546-5539
Mailing Address - Fax:
Practice Address - Street 1:18383 PRESTON RD STE 202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5487
Practice Address - Country:US
Practice Address - Phone:469-546-5539
Practice Address - Fax:469-546-9581
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135750363LP0808X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health