Provider Demographics
NPI:1841786589
Name:IGLESIAS, MANNHU BUI (DDS)
Entity Type:Individual
Prefix:DR
First Name:MANNHU
Middle Name:BUI
Last Name:IGLESIAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MANNHU
Other - Middle Name:TRUONG
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:804 E UPAS AVE APT A
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2391
Mailing Address - Country:US
Mailing Address - Phone:832-348-9438
Mailing Address - Fax:
Practice Address - Street 1:9820 BRAUN RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-9657
Practice Address - Country:US
Practice Address - Phone:214-466-1400
Practice Address - Fax:214-367-5896
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34308122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist