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NPI Code Detail

MEDICARE: MR. BRENT STEVEN MANNS PHARM D

MEDICARE: MR. BRENT STEVEN MANNS PHARM D
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
1183500000XPharmacist47895TX

General Provider Information

NPI Number : 1952638710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRENT STEVEN MANNS PHARM D
Provider Business Mailing Address
First Line : 3012 FRANCISCAN DR
Second Line : APT 624
City : ARLINGTON
State : TX
Zip : 76015-2544
Country : US
Telephone Number : 504-470-9381
Fax Number :
Provider Business Practice Location Address
First Line : 8120 S COCKRELL HILL RD
Second Line :
City : DALLAS
State : TX
Zip : 75236-9668
Country : US
Telephone Number : 972-283-1473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2009
Last Update Date : 11/15/2009

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