MEDICARE: CHRISTOPHER SCOTT MANATT 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	208800000X	Urology Physician	41133	AZ
2	208800000X	Urology Physician	N2638	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00890691	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	7604423386179	OTHER	TX	CHAMPUS TRICARE
3	002807191	OTHER	TX	UNITED HEALTH CARE
4	8FC798	OTHER	TX	BLUE CROSS/BLUE SHIELD OF TEXAS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588713358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER SCOTT MANATT M.D.

Provider Business Mailing Address
First Line	:	605 E SAN ANTONIO ST
Second Line	:	SUITE 509E
City	:	VICTORIA
State	:	TX
Zip	:	77901-6050
Country	:	US
Telephone Number	:	361-573-6351
Fax Number	:	361-575-6455

Provider Business Practice Location Address
First Line	:	605 E SAN ANTONIO ST
Second Line	:	SUITE 509E
City	:	VICTORIA
State	:	TX
Zip	:	77901-6050
Country	:	US
Telephone Number	:	361-573-6351
Fax Number	:	361-575-6455

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	09/06/2024

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Directions to “ CHRISTOPHER SCOTT MANATT M.D.” Practice Location

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