Provider Demographics
NPI:1225432834
Name:MANASES NIGHT CLINIC, P.A.
Entity Type:Organization
Organization Name:MANASES NIGHT CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-647-5342
Mailing Address - Street 1:4302 S SUGAR RD STE 106
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9140
Mailing Address - Country:US
Mailing Address - Phone:956-316-0260
Mailing Address - Fax:956-316-0263
Practice Address - Street 1:2302 S 77 SUNSHINESTRIP STE 102
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8371
Practice Address - Country:US
Practice Address - Phone:956-428-0022
Practice Address - Fax:956-421-5978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6573207Q00000X
TXK4124207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty