Basic Information
| Provider Information | |||||||||
| NPI: | 1326246638 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MANON | ||||||||
| FirstName: | JACINTO | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 749 | ||||||||
| Address2: | |||||||||
| City: | PHARR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785771614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563628500 | ||||||||
| FaxNumber: | 9563628529 | ||||||||
| Practice Location | |||||||||
| Address1: | 5519 DOCTORS DR | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785395563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563628500 | ||||||||
| FaxNumber: | 9563628505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2007 | ||||||||
| LastUpdateDate: | 08/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | S9740 | TX | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.