Pedrito Tualla Mangawang, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

12677 Issued in AZ

Practice address

5283 Old Brownsville Rd
Corpus Christi, TX 78405-3908

Phone

(361) 806-5600

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479513600000",
    "number": "1245265867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CONINE DR",
            "city": "ROBINSON",
            "state": "TX",
            "postal_code": "767066213",
            "telephone_number": "254-315-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5283 OLD BROWNSVILLE RD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784053908",
            "telephone_number": "361-806-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAWANG",
        "first_name": "PEDRITO",
        "middle_name": "TUALLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "12677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne Socorro Manalo, MD
• Wendy Karina Mancia, CRNA
• Janareddy Mandadi
• Jacquelynn Sosa Mandel, PHARMD
• Meghan Mandel, LCSW
• Adrienne Mangroo, R.D.
• Megan Mangrum, PT, DPT
• Jon F Manjarris, MD
• Stacy Lynn Manlove
• Manna Home Provider Services, LLC

• Internal Medicine Physician in Corpus Christi, TX
• Providers in Corpus Christi, 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 Nov 19, 2016; 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.