| Doctor Name: | CONSTANCE M MANNKE |
| NPI Number: | 1730358292 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 569311 |
| Business Practice Address: | 15200 S. Us 59 Hwy Suite 360 Sugarland, TX - 774784032 |
| Business Phone Number: | 8322373500 |
| Business Fax Number: | 8322370200 |
| Mailing Address: | 11321 Fallbrook Dr, HOUSTON |
| State: | TX |
| Postal Code: | 770654232 |
| Phone Number: | 8322373500 |
| Fax Number: | 8322370200 |
| NPI Enumeration Date: | 02/28/2008 |
| NPI Last Update Date: | 12/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | 569311 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |