Individual
DR. MARY MANUEL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
710 S 8TH ST, BEAUMONT, TX 77701-4642
(409) 838-9944
(409) 838-9086
Mailing address
710 S 8TH ST, BEAUMONT, TX 77701-4642
(409) 838-9944
(409) 838-9086
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
F1135
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00ER04
BLUE CROSS
TX
Enumeration date
06/17/2005
Last updated
07/08/2007
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