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General NPI Number Information
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NPI Number | 1225365208
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Entity Type | Individual
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Provider Name | SWAPNA MANTHENA M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/11/2009
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 901 CRYSTAL FALLS PKWY SUITE 150
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City | LEANDER
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State | TX
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Zip | 78641-1922
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Country | US
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Telephone | 512-259-2198
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Fax | 512-406-7374
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Provider Business Mailing Address
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Address Line | 6210 E HIGHWAY 290
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City | AUSTIN
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State | TX
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Zip | 78723-1142
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Country | US
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Telephone | 512-483-9596
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Fax | 512-406-6216
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 57-016811
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | P2487
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License Number State | TX
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