Individual
DR. MANISH RUNGTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1015 MEDICAL CENTER BLVD, SUITE 1700, WEBSTER, TX 77589-4011
(281) 480-6264
(281) 480-4046
Mailing address
1015 MEDICAL CENTER BLVD, SUITE 1700, WEBSTER, TX 77589-4011
(281) 480-6264
(281) 480-4046
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
L4686
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10016744
AMERIGROUP
TX
05
—
167491301
—
TX
01
—
23266
MHHNP
TX
01
—
7518588
AETNA PROVIDER NUMBER
TX
01
—
8K6291
BCBS PROVIDER NUMBER
TX
Enumeration date
08/10/2006
Last updated
10/20/2009
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