Individual
STEPHEN P MANISCALCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9201 PINECROFT DR, SUITE 210, SHENANDOAH, TX 77380-3222
(936) 441-1010
(832) 442-3081
Mailing address
920 MEDICAL PLAZA DR STE 360, SHENANDOAH, TX 77380-3271
(281) 803-8482
(281) 803-8432
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
L1655
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145174205
—
TX
Enumeration date
07/21/2006
Last updated
11/04/2020
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