Individual
ANDREA MAUREEN MANTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
1901 FM 718, AURORA, TX 76078-5213
(940) 206-1069
Mailing address
PO BOX 129, RHOME, TX 76078-0129
(940) 206-1069
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
10/24/2017
Last updated
07/17/2024
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