Provider Demographics
NPI:1780740886
Name:MANUEL A. TORRES, M.D., P.A.
Entity type:Organization
Organization Name:MANUEL A. TORRES, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:ARISTO
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-474-2660
Mailing Address - Street 1:1110 W WILLIAM CANNON DR
Mailing Address - Street 2:SUITE 502
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5468
Mailing Address - Country:US
Mailing Address - Phone:512-474-2660
Mailing Address - Fax:512-474-2170
Practice Address - Street 1:1110 W WILLIAM CANNON DR
Practice Address - Street 2:SUITE 502
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5468
Practice Address - Country:US
Practice Address - Phone:512-474-2660
Practice Address - Fax:512-474-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4853208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10012296OtherAMERIGROUP HEALTH PLAN ID
TX00DQ6KOtherBLUE CROSS BLUE SHIELD
TXEPSDT MEDICAID GROUPOtherEPSDT MEDICAID GROUP NUMB
E14664Medicare UPIN
TXEPSDT MEDICAID GROUPOtherEPSDT MEDICAID GROUP NUMB