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NPI Code Detail

MEDICARE: GEORGE MANLONGAT MD

MEDICARE: GEORGE MANLONGAT MD
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
1207Q00000XFamily Medicine PhysicianJ8655TX

General Provider Information

NPI Number : 1639109291
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE MANLONGAT MD
Provider Business Mailing Address
First Line : 1300 W TERRELL AVE STE K320
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2820
Country : US
Telephone Number : 817-250-5025
Fax Number : 817-250-1815
Provider Business Practice Location Address
First Line : 1301 PENNSYLVANIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2122
Country : US
Telephone Number : 817-250-2150
Fax Number : 817-250-5135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 05/04/2026

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Directions to “ GEORGE MANLONGAT MD” Practice Location

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