Individual
LUCIANO MANCERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2315 W BEN WHITE BLVD, AUSTIN, TX 78704-7524
(512) 326-5440
(512) 326-8660
Mailing address
2315 W BEN WHITE BLVD, AUSTIN, TX 78704-7524
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
321255
LA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
S5696
TX
Other
Enumeration date
04/18/2017
Last updated
12/12/2023
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