Organization
RONALD E. MANICOM, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA FOUSS (OFFICE MANAGER)
(512) 248-9000
Entity
Organization
Contact information
Practice address
1200 LAKEWAY DR, SUITE 8, LAKEWAY, TX 78734-4474
(512) 248-9000
(512) 248-9012
Mailing address
1200 LAKEWAY DR, SUITE 8, LAKEWAY, TX 78734-4474
(512) 248-9000
(512) 248-9012
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C9055
TX
Other
Enumeration date
02/23/2007
Last updated
11/20/2007
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