Provider Demographics
NPI:1013179951
Name:MANHAS, AMEETA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMEETA
Middle Name:
Last Name:MANHAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMEETA
Other - Middle Name:
Other - Last Name:MANHAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMEETA MANHAS, MD
Mailing Address - Street 1:4500 S LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7167
Mailing Address - Country:US
Mailing Address - Phone:214-307-1270
Mailing Address - Fax:
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-307-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2908122084P0800X, 2084P0805X, 2084P0800X
LAMD.2050232084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1061051Medicaid
LA321176YH54OtherMEDICARE - PTAN