Healthcare Provider Details

I. General information

NPI: 1659703023
Provider Name (Legal Business Name): MARYANN M EFESOA DNP, FNP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 SPINKS RD STE 133
FLOWER MOUND TX
75022-4451
US

IV. Provider business mailing address

2201 SPINKS RD STE 133
FLOWER MOUND TX
75022-4451
US

V. Phone/Fax

Practice location:
  • Phone: 469-309-7834
  • Fax: 469-252-7098
Mailing address:
  • Phone: 469-309-7834
  • Fax: 469-252-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP123893
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP123893
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: