Provider Demographics
NPI:1457536773
Name:MANOLAKOS, ANN (RN)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:MANOLAKOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17533
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-7533
Mailing Address - Country:US
Mailing Address - Phone:281-313-1889
Mailing Address - Fax:
Practice Address - Street 1:2538 SAGE BRUSH LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1607
Practice Address - Country:US
Practice Address - Phone:281-313-1889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-05
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX565838171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator