Individual
POONAM MEHTA MANASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
919 E 32ND ST, AUSTIN, TX 78705-2703
(512) 544-5116
(866) 735-4585
Mailing address
PO BOX 678895, DALLAS, TX 75267-8895
(727) 560-0522
(866) 735-4585
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME104594
FL
390200000X
Student in an Organized Health Care Education/Training Program
4301089924
MI
Other
Enumeration date
06/07/2007
Last updated
06/09/2021
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