MEDICARE: MANJIRI TULE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0203X	Pediatric Critical Care Medicine Physician	V5847	TX

General Provider Information

NPI Number	:	1588089569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANJIRI TULE

Provider Business Mailing Address
First Line	:	4910 MUELLER BLVD
Second Line	:	STE 100
City	:	AUSTIN
State	:	TX
Zip	:	78723
Country	:	US
Telephone Number	:	908-309-5039
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 MUELLER BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723
Country	:	US
Telephone Number	:	855-324-0091
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2014
Last Update Date	:	03/19/2026

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Directions to “ MANJIRI TULE ” Practice Location

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