Manicom, Ronald Edward
Manicom, Ronald Edward is an individual health care provider with primary practice located at 711 W 38Th St D-4, Austin TX 78705-1121. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Manicom, Ronald Edward can be contacted via phone (512) 454-9627.Contact Information
Primary practice address
711 W 38Th St D-4
Austin TX 78705-1121
Phone: (512) 454-9627
Fax: (512) 454-6310
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | C9055 | Texas |
Profile Details
| NPI number | 1427042159 |
|---|---|
| LBN Legal business name | Manicom, Ronald Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 8th, 2005 |
| Last updated | Jan 20th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427042159 | NPPES |
| Texas | MEDICAID | 180051801 |
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