Individual
JOSEPH RICHARD MANTHEIY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
132 BROADMOOR ST, MEADOWLAKES, TX 78654-6602
(830) 385-3641
Mailing address
132 BROADMOOR ST, MEADOWLAKES, TX 78654-6602
(830) 385-3641
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G8257
TX
207Q00000X
Family Medicine Physician
G8257
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125096103
—
TX
01
—
82990K
BCBS
TX
Enumeration date
11/18/2005
Last updated
10/25/2016
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