Individual
SAILAJA PURNA MANNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4330 MEDICAL DR, 5TH FLOOR, SAN ANTONIO, TX 78229-3342
(210) 732-3668
(210) 732-3338
Mailing address
4330 MEDICAL DR, 5TH FLOOR, SAN ANTONIO, TX 78229-3342
(210) 732-3668
(210) 732-3338
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
M6274
TX
207RR0500X
Rheumatology Physician
ME92873
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191007701
—
TX
01
—
8S1622
BCBS TEXAS
TX
01
—
TXB156839
WELLMED NETWORKS INC
TX
Enumeration date
05/17/2006
Last updated
01/31/2013
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