Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 1861 | TX |
Y | 213ES0131X | Foot Surgery | 1861 | TX |
NPI | 1023281581 |
---|---|
Provider Name | Dr. Nicolas Manriquez |
First Address | Houston, TX 77024-2301 |
Second Address | Richmond, TX 77469-7001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2008 |
Last Update Date | 08/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
194299701 | (05) | TX |
194299701 | MEDICAID PIN (01) | TX |
194299702 | (05) | TX |
194299703 | (05) | TX |
194299704 | (05) | TX |
194299705 | (05) | TX |
5476250001 | MEDICARE NSC (01) | TX |