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NPI Code Detail

MEDICARE: DR. MANUEL FERNANDEZ PALMER M.D.

MEDICARE: DR. MANUEL FERNANDEZ PALMER 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
1207R00000XInternal Medicine PhysicianQ4949TX
2207RN0300XNephrology PhysicianQ4949TX

General Provider Information

NPI Number : 1407136310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANUEL FERNANDEZ PALMER M.D.
Provider Business Mailing Address
First Line : 5940 CROSSLAKE PKWY
Second Line :
City : WACO
State : TX
Zip : 76712-6986
Country : US
Telephone Number : 254-666-2999
Fax Number :
Provider Business Practice Location Address
First Line : 5940 CROSSLAKE PKWY
Second Line :
City : WACO
State : TX
Zip : 76712-6986
Country : US
Telephone Number : 254-666-2999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2011
Last Update Date : 06/09/2016

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