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General NPI Number Information
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NPI Number | 1841516739
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Entity Type | Organization
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Legal Business Name | BRUCE E MANIET DO PA
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 101 S BROADWAY ST
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City | BELLS
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State | TX
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Zip | 75414-2696
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Country | US
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Telephone | 903-965-7700
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Fax | 903-965-7623
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Provider Business Mailing Address
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Address Line | PO BOX 207
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City | BELLS
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State | TX
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Zip | 75414-0207
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Country | US
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Telephone | 903-965-7700
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Fax | 903-965-7623
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BRUCE E MANIET
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Credential | DO
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Telephone | 903-965-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H8741
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License Number State | TX
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