Provider Demographics
NPI:1780283234
Name:MANESH, DANIEL (DNP, FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:MANESH
Suffix:
Gender:M
Credentials:DNP, FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9414 PEGASUS RUN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6216
Mailing Address - Country:US
Mailing Address - Phone:210-957-9382
Mailing Address - Fax:
Practice Address - Street 1:915 S LAREDO ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78204-3211
Practice Address - Country:US
Practice Address - Phone:210-277-1418
Practice Address - Fax:210-277-1458
Is Sole Proprietor?:No
Enumeration Date:2020-10-25
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX861682163W00000X
TX1031933363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily