Provider Demographics
NPI:1124343637
Name:MANNERING, ISHA (MD)
Entity type:Individual
Prefix:DR
First Name:ISHA
Middle Name:
Last Name:MANNERING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4461 COIT RD STE 405
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0531
Mailing Address - Country:US
Mailing Address - Phone:972-526-0700
Mailing Address - Fax:
Practice Address - Street 1:4461 COIT RD STE 405
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0531
Practice Address - Country:US
Practice Address - Phone:972-526-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5416208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program