Provider Demographics
NPI:1790125680
Name:MANEK, LENA RAMESH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LENA
Middle Name:RAMESH
Last Name:MANEK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4471 EASTPORT PARK WAY
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-6041
Mailing Address - Country:US
Mailing Address - Phone:386-214-8124
Mailing Address - Fax:
Practice Address - Street 1:6213 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7036
Practice Address - Country:US
Practice Address - Phone:713-880-4400
Practice Address - Fax:713-869-8637
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1230629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist