Basic Information
| Provider Information | |||||||||
| NPI: | 1033448303 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEDNEKAR | ||||||||
| FirstName: | MANALI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 FROSTWOOD DR STE 1.100 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770242301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133386353 | ||||||||
| FaxNumber: | 7131073086 | ||||||||
| Practice Location | |||||||||
| Address1: | 18951 N MEMORIAL DR STE 103W | ||||||||
| Address2: | |||||||||
| City: | HUMBLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773384217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815408409 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2009 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Q5247 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | Q5247 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208M00000X | Q5247 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.