Provider Demographics
NPI:1184466674
Name:MCMANUS, VIKHANA
Entity type:Individual
Prefix:MR
First Name:VIKHANA
Middle Name:
Last Name:MCMANUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3663 CEDAR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5050
Mailing Address - Country:US
Mailing Address - Phone:318-918-9980
Mailing Address - Fax:
Practice Address - Street 1:2150 LAKESIDE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4467
Practice Address - Country:US
Practice Address - Phone:972-437-4698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool