Provider Demographics
NPI:1821659798
Name:MANNIL, SALEEN GIGI (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SALEEN
Middle Name:GIGI
Last Name:MANNIL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:SALEEN
Other - Middle Name:
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:780 CLEAR LAKE CITY BLVD BLDG 2
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-5500
Mailing Address - Country:US
Mailing Address - Phone:281-464-8988
Mailing Address - Fax:281-464-7744
Practice Address - Street 1:780 CLEAR LAKE CITY BLVD BLDG 2
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-5500
Practice Address - Country:US
Practice Address - Phone:281-464-8988
Practice Address - Fax:281-464-7744
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140199363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology