Provider Demographics
NPI: | 1508253402 |
---|---|
Name: | MANAKTALA, ROHINI (DO) |
Entity Type: | Individual |
Prefix: | |
First Name: | ROHINI |
Middle Name: | |
Last Name: | MANAKTALA |
Suffix: | |
Gender: | F |
Credentials: | DO |
Other - Prefix: | |
Other - First Name: | ROHINI |
Other - Middle Name: | |
Other - Last Name: | MANAKTALA |
Other - Suffix: | |
Other - Last Name Type: | Professional Name |
Other - Credentials: | DO |
Mailing Address - Street 1: | MEMORIAL HERMANN SOUTHWEST HOSPITAL |
Mailing Address - Street 2: | 7600 BEECHNUT STREET |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77074 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-456-5000 |
Mailing Address - Fax: | 504-842-3278 |
Practice Address - Street 1: | MEMORIAL HERMANN HEART & VASCULAR INSTITUTE-SOUTHWEST |
Practice Address - Street 2: | 7787 BEECHNUT STREET |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77074 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-272-1609 |
Practice Address - Fax: | 713-272-1615 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2015-04-20 |
Last Update Date: | 2023-05-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | T5383 | 207RC0000X, 207RI0011X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |