Provider Demographics
NPI:1295571461
Name:MANOA, DAVID SEBAHIZI
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SEBAHIZI
Last Name:MANOA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7313 DUNGAREES WAY
Mailing Address - Street 2:
Mailing Address - City:DEL VALLE
Mailing Address - State:TX
Mailing Address - Zip Code:78617-3257
Mailing Address - Country:US
Mailing Address - Phone:619-358-5862
Mailing Address - Fax:
Practice Address - Street 1:7313 DUNGAREES WAY
Practice Address - Street 2:
Practice Address - City:DEL VALLE
Practice Address - State:TX
Practice Address - Zip Code:78617-3257
Practice Address - Country:US
Practice Address - Phone:619-358-5862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-06
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)