Individual
TERESITA MANIGBAS IDEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-4000
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
453710
TX
363L00000X
Nurse Practitioner
Primary
AP143989
TX
363LF0000X
Family Nurse Practitioner
AP143989
TX
Other
Enumeration date
10/25/2019
Last updated
08/18/2022
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