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Individual

MRS. JAN MANAGBANAG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11846 ABBOTTSWOOD ST, SAN ANTONIO, TX 78249-3005
(210) 269-7044
Mailing address
11846 ABBOTTSWOOD ST, SAN ANTONIO, TX 78249-3005
(210) 269-7044

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
862061
TX
133VN1005X
Renal Nutrition Registered Dietitian
DT05066
TX

Other

Enumeration date
05/25/2010
Last updated
05/25/2010
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