Basic Information
Provider Information
NPI: 1447463690
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: MANISH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5358
Address2:  
City: MCALLEN
State: TX
PostalCode: 785025358
CountryCode: US
TelephoneNumber: 9563625673
FaxNumber: 9563622038
Practice Location
Address1: 5500 RAPHAEL DR
Address2:  
City: EDINBURG
State: TX
PostalCode: 78539
CountryCode: US
TelephoneNumber: 9563625673
FaxNumber: 9563622038
Other Information
ProviderEnumerationDate: 05/07/2007
LastUpdateDate: 11/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X0101264425VAN Allopathic & Osteopathic PhysiciansSurgery 
208600000XP0498TXY Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
144746369005VA MEDICAID
66584101VAMEDICAREOTHER


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