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Individual
STACEY L MANION
Active
Individual
STACEY L MANION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
P7292
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331189606
—
TX
01
—
760358
MEDICARE
TX
Enumeration date
05/12/2010
Last updated
04/07/2020
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