Provider Demographics
NPI:1942572599
Name:MANRIQUE NEIRA, CARLOS R (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:R
Last Name:MANRIQUE NEIRA
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 1:6400 FANNIN ST STE 2350
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1554
Mailing Address - Country:US
Mailing Address - Phone:713-486-6740
Mailing Address - Fax:
Practice Address - Street 1:6400 FANNIN ST STE 2350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-486-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-28
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8783207RC0000X, 207RA0001X
NY284693207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease