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NPI Code Detail

MEDICARE: CIERA MANGUM

MEDICARE: CIERA MANGUM
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
1224Z00000XOccupational Therapy Assistant215710TX

General Provider Information

NPI Number : 1851244297
Entity Type Code : Individual
Provider Name (Legal Business Name) : CIERA MANGUM
Provider Business Mailing Address
First Line : 613 CRESTHAVEN DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-7864
Country : US
Telephone Number : 214-623-5623
Fax Number :
Provider Business Practice Location Address
First Line : 613 CRESTHAVEN DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-7864
Country : US
Telephone Number : 214-623-5623
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2026
Last Update Date : 02/17/2026

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Directions to “ CIERA MANGUM ” Practice Location

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