Individual
THERESA MANRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7951 SHOAL CREEK BLVD STE 200, AUSTIN, TX 78757-7581
(512) 454-4588
(512) 459-9869
Mailing address
PO BOX 10597, AUSTIN, TX 78766-1597
(512) 485-5889
(512) 420-0397
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA13127
TX
Other
Enumeration date
10/01/2020
Last updated
08/11/2023
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