Provider Demographics
NPI:1760772560
Name:MANUEL, NEREIDA MARIA (ARNP)
Entity Type:Individual
Prefix:
First Name:NEREIDA
Middle Name:MARIA
Last Name:MANUEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 HARRISBURG BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011-4229
Mailing Address - Country:US
Mailing Address - Phone:832-275-2696
Mailing Address - Fax:832-834-6075
Practice Address - Street 1:5201 HARRISBURG BLVD STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-4229
Practice Address - Country:US
Practice Address - Phone:832-275-2696
Practice Address - Fax:832-834-6075
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134733363LF0000X
FLARNP9296293363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760772560Other1760772560