Provider Demographics
NPI:1881646974
Name:MANCINI, RALPH MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:MICHAEL
Last Name:MANCINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 925510
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77292-5510
Mailing Address - Country:US
Mailing Address - Phone:713-984-9595
Mailing Address - Fax:713-984-8576
Practice Address - Street 1:1044 CANDLELIGHT LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-2004
Practice Address - Country:US
Practice Address - Phone:713-984-9595
Practice Address - Fax:713-984-8576
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7178208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89G540OtherMEDICARE PTAN
TX117137302Medicaid
TX117137302Medicaid
TXC18727Medicare UPIN