Provider Demographics
NPI:1689310526
Name:MANAS, ANITRA (MSP, BSHA, AAHA)
Entity Type:Individual
Prefix:
First Name:ANITRA
Middle Name:
Last Name:MANAS
Suffix:
Gender:F
Credentials:MSP, BSHA, AAHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 S BENDER AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4340
Mailing Address - Country:US
Mailing Address - Phone:832-367-7094
Mailing Address - Fax:
Practice Address - Street 1:424 S BENDER AVE
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4325
Practice Address - Country:US
Practice Address - Phone:832-367-7094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
TX225A00000X, 251J00000X, 374U00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No171400000XOther Service ProvidersHealth & Wellness Coach
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No251J00000XAgenciesNursing Care
No374U00000XNursing Service Related ProvidersHome Health Aide