Provider Demographics
NPI:1891794616
Name:MANLLO-KARIM, ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:MANLLO-KARIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1228
Mailing Address - Country:US
Mailing Address - Phone:956-631-6136
Mailing Address - Fax:956-631-1848
Practice Address - Street 1:1901 S 1ST ST
Practice Address - Street 2:STE 600
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1228
Practice Address - Country:US
Practice Address - Phone:956-631-6136
Practice Address - Fax:956-631-1848
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2181207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
39005176OtherPALMETTO MEDICARE RAILROAD
TX131918803Medicaid
TX131918803Medicaid