Individual
JONATHAN PAUL MANNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 21ST ST, LUBBOCK, TX 79410-1229
(806) 791-0399
(806) 791-0373
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
Q8746
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
221101200
FIRSTCARE
TX
05
—
360501601
—
TX
01
—
519360YKT8
MEDICARE
TX
05
—
84977060
—
NM
01
—
8GC015
BCBS TX
TX
Enumeration date
05/05/2009
Last updated
01/20/2022
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