Provider Demographics
NPI:1821513060
Name:MANAS, DANIEL (PT, DPT, OCS, CSCS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MANAS
Suffix:
Gender:M
Credentials:PT, DPT, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13009 LAMPLIGHT VILLAGE AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-3229
Mailing Address - Country:US
Mailing Address - Phone:318-218-1616
Mailing Address - Fax:
Practice Address - Street 1:13009 LAMPLIGHT VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-3229
Practice Address - Country:US
Practice Address - Phone:318-218-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1287111225100000X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist