Provider Demographics
NPI:1609131713
Name:MANN EYE CENTER, PA
Entity Type:Organization
Organization Name:MANN EYE CENTER, PA
Other - Org Name:MANN EYE INSTITUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORD
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:713-275-2457
Mailing Address - Street 1:PO BOX 659506
Mailing Address - Street 2:DEPT 2181
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78265-9506
Mailing Address - Country:US
Mailing Address - Phone:713-275-2461
Mailing Address - Fax:713-275-2496
Practice Address - Street 1:4314 W BRAKER LN
Practice Address - Street 2:SUITE 215
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5358
Practice Address - Country:US
Practice Address - Phone:512-327-4123
Practice Address - Fax:512-327-9156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB112283Medicare PIN