Provider Demographics
NPI:1265658025
Name:MCMANUS, WILLIAM EDWARD (PA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:MCMANUS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3101 HIGHWAY 71 E
Mailing Address - Street 2:#101
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-5159
Mailing Address - Country:US
Mailing Address - Phone:512-304-0300
Mailing Address - Fax:512-304-0341
Practice Address - Street 1:3101 HIGHWAY 71 E
Practice Address - Street 2:SUITE 101
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-5156
Practice Address - Country:US
Practice Address - Phone:512-304-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEMPORARY363AM0700X
TXPA05237363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical