Organization
MANUEL A. TORRES, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL ARISTO TORRES M.D. (PRESIDENT)
(512) 474-2660
Entity
Organization
Contact information
Practice address
1110 W WILLIAM CANNON DR, SUITE 502, AUSTIN, TX 78745-5468
(512) 474-2660
(512) 474-2170
Mailing address
1110 W WILLIAM CANNON DR, SUITE 502, AUSTIN, TX 78745-5468
(512) 474-2660
(512) 474-2170
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
H4853
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00DQ6K
BLUE CROSS BLUE SHIELD
TX
01
—
10012296
AMERIGROUP HEALTH PLAN ID
TX
01
—
EPSDT MEDICAID GROUP
EPSDT MEDICAID GROUP NUMB
TX
Enumeration date
12/31/2006
Last updated
08/22/2020
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