Provider Demographics
NPI:1194234658
Name:MANUEL, DARLENE MAY (PT)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:MAY
Last Name:MANUEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 ARBOR RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3724
Mailing Address - Country:US
Mailing Address - Phone:504-495-1716
Mailing Address - Fax:
Practice Address - Street 1:4100 N SAM HOUSTON PKWY W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086-1465
Practice Address - Country:US
Practice Address - Phone:214-466-1375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX027322251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics