MEDICARE: MARIA GERALDINE ZUNIGA MANRIQUE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YX0901X	Otology & Neurotology Physician	T7404	TX
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1215370077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA GERALDINE ZUNIGA MANRIQUE M.D.

Provider Business Mailing Address
First Line	:	21 SPURS LN STE 245
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1689
Country	:	US
Telephone Number	:	210-547-1550
Fax Number	:	210-615-6814

Provider Business Practice Location Address
First Line	:	21 SPURS LN STE 245
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1689
Country	:	US
Telephone Number	:	210-547-1550
Fax Number	:	210-615-6814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2013
Last Update Date	:	06/02/2022

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