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Individual
MR. RENE SOAN MANUEL
Active
Individual
MR. RENE SOAN MANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1047017
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00690Y
MEDICARE
TX
01
—
8E0318
MEDICARE
TX
01
—
98ME
BCBS
TX
Enumeration date
08/14/2007
Last updated
08/14/2007
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