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General NPI Number Information
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NPI Number | 1194794610
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Entity Type | Individual
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Provider Name | MANAN S. SHUKLA MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 450 W MEDICAL CENTER BLVD SUITE 203
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City | WEBSTER
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State | TX
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Zip | 77598-4234
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Country | US
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Telephone | 832-906-2500
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Fax | 832-906-2501
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Provider Business Mailing Address
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Address Line | 450 W MEDICAL CENTER BLVD SUITE 203
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City | WEBSTER
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State | TX
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Zip | 77598-4234
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Country | US
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Telephone | 832-906-2500
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Fax | 832-906-2501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036091485
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 43570
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N9300
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License Number State | TX
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