Provider Demographics
NPI:1275773947
Name:MANN, TODD ROBERT (REEGT, CNIM)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:ROBERT
Last Name:MANN
Suffix:
Gender:M
Credentials:REEGT, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5761 BERNAY LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2905
Mailing Address - Country:US
Mailing Address - Phone:972-403-1938
Mailing Address - Fax:972-403-1006
Practice Address - Street 1:5761 BERNAY LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2905
Practice Address - Country:US
Practice Address - Phone:972-403-1938
Practice Address - Fax:972-403-1006
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1165246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic