Provider Demographics
NPI:1750565610
Name:MANCERA, ANTONIO E (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:E
Last Name:MANCERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 MCPHERSON RD
Mailing Address - Street 2:SUITE N230
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6507
Mailing Address - Country:US
Mailing Address - Phone:956-728-8121
Mailing Address - Fax:
Practice Address - Street 1:7210 MCPHERSON RD
Practice Address - Street 2:SUITE N230
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6507
Practice Address - Country:US
Practice Address - Phone:956-728-8121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5832207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology