Individual
DR. LIEM THANH MANSFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 E BEAUREGARD AVE, SAN ANGELO, TX 76903-5919
(325) 747-1511
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 747-1511
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
L6511
TX
2085R0202X
Diagnostic Radiology Physician
Primary
L6511
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L6511
TEXAS MEDICAL LICENSE
TX
Enumeration date
10/25/2005
Last updated
02/14/2024
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