Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | M2966 | TX |
NPI | 1043243595 |
---|---|
Provider Name | Manjusha Gunuganti |
First Address | San Antonio, TX 78258-7500 |
Second Address | San Antonio, TX 78205-1201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 08/07/2007 |