Provider Demographics
NPI:1023326790
Name:MANDA INVESTMENTS,LLC
Entity type:Organization
Organization Name:MANDA INVESTMENTS,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-399-0202
Mailing Address - Street 1:16607 BLANCO RD
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1913
Mailing Address - Country:US
Mailing Address - Phone:210-399-0202
Mailing Address - Fax:210-399-4840
Practice Address - Street 1:16607 BLANCO RD
Practice Address - Street 2:SUITE 901
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1913
Practice Address - Country:US
Practice Address - Phone:210-399-0202
Practice Address - Fax:210-399-4840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32037632984OtherTEXAS / COMPTROLLER OF PUBLIC ACCOUNTS