MEDICARE: COLETTE MANNING OD PC

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	152W00000X	Optometrist	4511T	TX

General Provider Information

NPI Number	:	1659540961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLETTE MANNING OD PC

Provider Business Mailing Address
First Line	:	6808 POTOMAC PKWY
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-4940
Country	:	US
Telephone Number	:	817-294-7456
Fax Number	:	817-294-5443

Provider Business Practice Location Address
First Line	:	6808 POTOMAC PKWY
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-4940
Country	:	US
Telephone Number	:	817-294-7456
Fax Number	:	817-294-5443

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. COLETTE MANNING
Credential	:	O.D.
Telephone Number	:	817-294-7456

Provider Enumeration Date	:	02/21/2008
Last Update Date	:	05/30/2025

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