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General NPI Number Information
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NPI Number | 1679849558
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Entity Type | Individual
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Provider Name | LAKSHMI MANASA JONNA M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2012
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Last Update Date | 01/12/2020
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Provider Practice Location Address
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Address Line | 6621 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2358
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Country | US
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Telephone | 832-824-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 6621 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2358
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Country | US
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Telephone | 832-824-1000
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Fax |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | ME134778
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License Number State | FL
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