Manuel Griego Jr. DO PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F1604 Issued in TX

Legal business name

MANUEL GRIEGO JR. DO PA

Practice address

3116 Martin Luther King Jr Blvd
Dallas, TX 75215-2414

Phone

(214) 329-3300

NPI assigned

Jul 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Manuel Griego Jr., DO

Title

Ceo/President

Phone

(214) 580-7277

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fair Park Medical Centre Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278374400000",
    "number": "1033309869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 MAIN ST",
            "address_2": "SUITE 905",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752024014",
            "telephone_number": "214-580-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 MARTIN LUTHER KING JR BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752152414",
            "telephone_number": "214-329-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL GRIEGO JR. DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2010-07-06",
        "status": "A",
        "authorized_official_last_name": "GRIEGO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "214-580-7277",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F1604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P000HL68",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fair Park Medical Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Parvez Mantry, MD
• Elizabeth Mantsch
• Manuel Griego Jr DO PA
• Manuel Griego Jr DO PA
• Manuel Griego Jr DO PA
• Manuel Griego Jr. DO PA
• Manuel Griego, Jr. D.O., P.a.
• Manuel Tellez, D.O., P.a.
• Cherlindra Lenell Manus, BS, QMHP
• Kangamwirai Manyanga, PMHNP-BC

• Family Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.