Manju Poovathoor, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

L8892 Issued in TX

Practice address

7330 San Pedro Ave
Suite: 540
San Antonio, TX 78216-6235

Phone

(210) 344-2673

Fax

(210) 344-2649

NPI assigned

Sep 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Inpatient Consultants of Texas, PLLC

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1255642716
  NPD (past)
• Ipc Healthcare Services of Texas, PLLC

  • Hospitalist Physician
  • San Antonio, TX
  • NPI 1023403011

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1194821801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 SAN PEDRO AVE",
            "address_2": "SUITE: 540",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166235",
            "telephone_number": "210-344-2673",
            "fax_number": "210-344-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 SAN PEDRO AVE",
            "address_2": "SUITE: 540",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166235",
            "telephone_number": "210-344-2673",
            "fax_number": "210-344-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOVATHOOR",
        "first_name": "MANJU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L8892",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "L8892",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169276601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nia Poole
• Jason Poon
• Danielle Lee Poor, DPT
• Fred F Poordad, M.D.
• Alexis Kaitlyn Poore
• Edward Pope, LCSW
• Abigail Popelar, CRNA
• Rena M Popma, PSY.D
• Femi Popoola, MD
• David W Popp, MD

• Internal Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.