Provider Demographics
NPI:1992780118
Name:MANUEL, WILLIAM S (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:MANUEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1200 BINZ ST STE 1490
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6946
Mailing Address - Country:US
Mailing Address - Phone:713-512-7027
Mailing Address - Fax:
Practice Address - Street 1:4801 WOODWAY DR STE 373W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-1887
Practice Address - Country:US
Practice Address - Phone:713-528-3366
Practice Address - Fax:713-600-9002
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6276207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX721645OtherTX MEDICARE
TXM6276OtherTX MEDICAL LICENSE
MAJ27961OtherBCBS MA
MA2079470Medicaid
TX8KG697OtherBCBS TX
MA469771OtherTUFTS HEALTH PLAN