Provider Demographics
NPI:1174651525
Name:INFANTE, MANUEL ARTURO
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:ARTURO
Last Name:INFANTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 LEE TREVINO
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936
Mailing Address - Country:US
Mailing Address - Phone:915-534-1182
Mailing Address - Fax:915-599-9751
Practice Address - Street 1:3100 LEE TREVINO
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-594-1182
Practice Address - Fax:915-599-9751
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107892225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP6032Medicare UPIN
TX8E0192Medicare ID - Type Unspecified