Organization Name: | REX MANN MD PA |
NPI Number: | 1629363882 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | REX L MANN (OWNER) |
Mailing Address: | 3019 S Main St Perryton |
State: | TX US |
Postal Code: | 790705357 |
Phone Number: | 8064357154 |
Fax Number: | 8064356909 |
NPI Enumeration Date: | 06/16/2011 |
NPI Last Update Date: | 08/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G3581 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |