Provider Demographics
NPI:1316985583
Name:MANN, MICHAEL W (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:32665 US HIGHWAY 281 N
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-3124
Mailing Address - Country:US
Mailing Address - Phone:830-980-9686
Mailing Address - Fax:830-438-3423
Practice Address - Street 1:32665 US HIGHWAY 281 N
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-3124
Practice Address - Country:US
Practice Address - Phone:830-980-9686
Practice Address - Fax:830-438-3423
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100188503Medicaid
TX100188504Medicaid
TXP00415648OtherPALMETTO GBA RAILROAD MED
TX8G9429Medicare PIN
TXF88667Medicare UPIN
TX100188503Medicaid