Organization
MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA V MANAX M.D. (CO-OWNER)
(254) 694-9400
Entity
Organization
Contact information
Practice address
203 A EAST JEFFERSON, WHITNEY, TX 76692
(254) 694-9400
(254) 694-9175
Mailing address
PO BOX 2570, WHITNEY, TX 76692-5570
(254) 694-9400
(254) 694-9175
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
F7521
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88600Y
BCBS
TX
Enumeration date
12/13/2006
Last updated
08/22/2020
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