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General NPI Number Information
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NPI Number | 1255575387
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Entity Type | Organization
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Legal Business Name | EDWARD TOMANENG MD, PA
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 07/15/2009
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Provider Practice Location Address
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Address Line | 2000 MEDICAL PKWY STE C
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City | SAN MARCOS
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State | TX
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Zip | 78666-7583
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Country | US
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Telephone | 512-353-8899
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Fax | 512-353-8311
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Provider Business Mailing Address
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Address Line | 2000 MEDICAL PKWY STE C
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City | SAN MARCOS
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State | TX
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Zip | 78666-7583
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Country | US
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Telephone | 512-353-8899
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Fax | 512-353-8311
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Authorized Official
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Title or Position | OWNER
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Name | EDWARD U TOMANENG
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Credential | M.D.
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Telephone | 512-353-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G7897
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License Number State | TX
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