Provider Demographics
NPI:1396864278
Name:JON F. MANJARRIS, M.D.
Entity Type:Organization
Organization Name:JON F. MANJARRIS, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:F
Authorized Official - Last Name:MANJARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-241-0324
Mailing Address - Street 1:14317 NW BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CRP CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-5536
Mailing Address - Country:US
Mailing Address - Phone:361-241-0324
Mailing Address - Fax:
Practice Address - Street 1:14317 NW BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:CRP CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5536
Practice Address - Country:US
Practice Address - Phone:361-241-0324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1772207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty