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General NPI Number Information
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NPI Number | 1225432834
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Entity Type | Organization
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Legal Business Name | MANASES NIGHT CLINIC, P.A.
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Dates
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Enumeration Date | 10/13/2014
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 2302 S 77 SUNSHINESTRIP STE 102
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City | HARLINGEN
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State | TX
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Zip | 78550-8371
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Country | US
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Telephone | 956-428-0022
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Fax | 956-421-5978
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Provider Business Mailing Address
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Address Line | 4302 S SUGAR RD STE 106
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City | EDINBURG
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State | TX
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Zip | 78539-9140
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Country | US
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Telephone | 956-316-0260
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Fax | 956-316-0263
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW LEVINE
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Credential | M.D.
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Telephone | 956-647-5342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | K4124
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License Number State | TX
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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 | H6573
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License Number State | TX
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