Basic Information
| Provider Information | |||||||||
| NPI: | 1063605129 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MANN | ||||||||
| FirstName: | AMIT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15134 KING OF SPAIN CT | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752486426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177185495 | ||||||||
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| Practice Location | |||||||||
| Address1: | 221 W COLORADO BLVD | ||||||||
| Address2: | PAV II, SUITE 528 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752082363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149605681 | ||||||||
| FaxNumber: | 2149472727 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2007 | ||||||||
| LastUpdateDate: | 07/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | M9480 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.