Provider Demographics
NPI:1164470878
Name:MANJI, NASRULLAH (MD)
Entity Type:Individual
Prefix:DR
First Name:NASRULLAH
Middle Name:
Last Name:MANJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4646 HIGHWAY 6
Mailing Address - Street 2:BOX 147
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5214
Mailing Address - Country:US
Mailing Address - Phone:281-491-9387
Mailing Address - Fax:281-491-9391
Practice Address - Street 1:4760 SWEETWATER BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3172
Practice Address - Country:US
Practice Address - Phone:281-491-9387
Practice Address - Fax:281-491-9391
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJO993207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F08244Medicare UPIN
TXOOH59MMedicare PIN