MEDICARE: DR. MICHAEL THOMAS MANN 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	207P00000X	Emergency Medicine Physician	N3162	TX

General Provider Information

NPI Number	:	1356592893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL THOMAS MANN M.D.

Provider Business Mailing Address
First Line	:	2926 NOTTINGHAM ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-2326
Country	:	US
Telephone Number	:	832-409-9222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2926 NOTTINGHAM ST
Second Line	:	DEPARTMENT OF EMERGENCY MEDICINE
City	:	HOUSTON
State	:	TX
Zip	:	77005-2326
Country	:	US
Telephone Number	:	832-409-9222
Fax Number	:

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

Provider Enumeration Date	:	10/02/2008
Last Update Date	:	02/08/2010

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