Provider Demographics
NPI:1952638710
Name:MANNS, BRENT STEVEN (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:BRENT
Middle Name:STEVEN
Last Name:MANNS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 FRANCISCAN DR
Mailing Address - Street 2:APT 624
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2544
Mailing Address - Country:US
Mailing Address - Phone:504-470-9381
Mailing Address - Fax:
Practice Address - Street 1:8120 S COCKRELL HILL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75236-9668
Practice Address - Country:US
Practice Address - Phone:972-283-1473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-15
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist