MEDICARE: MR. ENRIQUE MOLANO-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	207Q00000X	Family Medicine Physician	E0561	TX

General Provider Information

NPI Number	:	1437118924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ENRIQUE MOLANO-MANRIQUE M.D.

Provider Business Mailing Address
First Line	:	908 E SOUTHMORE AVE
Second Line	:	SUITE 140
City	:	PASADENA
State	:	TX
Zip	:	77502-1134
Country	:	US
Telephone Number	:	713-477-6913
Fax Number	:

Provider Business Practice Location Address
First Line	:	908 E SOUTHMORE AVE
Second Line	:	SUITE 140
City	:	PASADENA
State	:	TX
Zip	:	77502-1134
Country	:	US
Telephone Number	:	713-477-6913
Fax Number	:

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	07/08/2007

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