Physician Compare National (NPI:1750565610)

HEALTHCARE PROVIDER: ANTONIO E. MANCERA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1750565610
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9234385832
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120815000463
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MANCERA
	Individual professional last name
Provider First Name	ANTONIO
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	RHEUMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LAREDO ARTHRITIS AND RHEUMATOLOGY CENTER PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1153577747
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	7
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	10410 MEDICAL LOOP
	Group Practice or individual's line 1 address
Line 2 Street Address	BLDG 6B
	Group Practice or individual's line 2 address
City	LAREDO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	780456906
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9567288121
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450029
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LAREDO MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450643
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	DOCTORS HOSPITAL OF LAREDO
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	451390
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	DIMMIT REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y