Individual
ANJI R MANTHENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 MEDICAL CENTER BLVD, WEBSTER, TX 77598-4220
(281) 332-3230
Mailing address
1906 RAY SHELL CT, SEABROOK, TX 77586-4585
(281) 291-8226
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F0631
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097466901
—
TX
Enumeration date
10/02/2006
Last updated
01/22/2013
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