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General NPI Number Information
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NPI Number | 1790405298
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Entity Type | Organization
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Legal Business Name | MANOR BIRTH SANCTUARY
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Dates
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Enumeration Date | 09/02/2022
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 7103 WELLS TRCE
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City | MANOR
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State | TX
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Zip | 78653-4155
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Country | US
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Telephone | 512-653-7892
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Fax |
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Provider Business Mailing Address
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Address Line | 7103 WELLS TRCE
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City | MANOR
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State | TX
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Zip | 78653-4155
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VICTORIA MEINHARDT
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Credential | CPM, LM
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Telephone | 512-653-7892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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