Provider Demographics
NPI:1114934429
Name:MIER, MANUEL JESUS JR (SA-C)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:JESUS
Last Name:MIER
Suffix:JR
Gender:M
Credentials:SA-C
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Mailing Address - Street 1:PO BOX 581
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-0581
Mailing Address - Country:US
Mailing Address - Phone:210-875-6309
Mailing Address - Fax:210-547-2831
Practice Address - Street 1:19051 BANDERA RD
Practice Address - Street 2:#2
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-2803
Practice Address - Country:US
Practice Address - Phone:210-875-6309
Practice Address - Fax:210-547-2831
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2017-04-18
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical