Provider Demographics
NPI:1073973723
Name:ARANGUREN, MANUEL
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:ARANGUREN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MANUEL
Other - Middle Name:EDUARDO
Other - Last Name:ARANGUREN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:4255 BRYANT IRVIN RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4233
Mailing Address - Country:US
Mailing Address - Phone:214-730-8509
Mailing Address - Fax:
Practice Address - Street 1:4255 BRYANT IRVIN RD
Practice Address - Street 2:SUITE 108
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4233
Practice Address - Country:US
Practice Address - Phone:817-731-4848
Practice Address - Fax:817-731-4858
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111349225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist