Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | M0479 | TX |
Y | 2084N0402X | Child Neurologist | M0479 | TX |
NPI | 1336169945 |
---|---|
Provider Name | Dr. Priti M Manohar |
First Address | Mcallen, TX 78502-4784 |
Second Address | Edinburg, TX 78539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 03/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
173741301 | (05) | TX |
I25488 | (02) | TX |