Individual
MR. ERIC MANTHURUTHIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5939 HARRY HINES BLVD, DALLAS, TX 75390
(214) 645-2100
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
(817) 707-5636
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10504
TX
363A00000X
Physician Assistant
—
TX
Other
Enumeration date
02/12/2016
Last updated
08/23/2019
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