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General NPI Number Information
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NPI Number | 1770842098
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Entity Type | Organization
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Legal Business Name | LAREDO ARTHRITIS & RHEUMATOLOGY CENTER, PLLC
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Dates
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Enumeration Date | 05/07/2012
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 7210 MCPHERSON RD N230
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City | LAREDO
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State | TX
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Zip | 78041-6507
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Country | US
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Telephone | 210-421-4131
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Fax |
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Provider Business Mailing Address
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Address Line | 7210 MCPHERSON RD N230
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City | LAREDO
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State | TX
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Zip | 78041-6507
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Country | US
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Telephone | 210-421-4131
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTONIO EMANUEL MANCERA
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Credential | M.D.
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Telephone | 210-421-4131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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