Raymond Pampolina Manahan, IDC

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

905 La Mirada
Portland, TX 78374-4130

Phone

(361) 776-4569

NPI assigned

Sep 12, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1417142431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 LA MIRADA",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783744130",
            "telephone_number": "361-776-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 LA MIRADA",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783744130",
            "telephone_number": "361-776-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANAHAN",
        "first_name": "RAYMOND",
        "middle_name": "PAMPOLINA",
        "name_prefix": "Mr.",
        "credential": "IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Marie Lindsey, SLP
• Lone Star Evaluations Inc. (Occucare International)
• Rebecca Lovins
• Luxottica of America Inc (Target Optical P739)
• Sumeet Singh Malhotra, DMD
• Angela Garcia Marroquin, SLP - INTER
• Joseph Daniel Martinez, PHARMD
• Lorraine Elizabeth Martinez, MS-SLP-CCC
• Shelby Danielle Martinez, PHARMD
• Michael Landers Mauldin, D.D.S.

• Independent Duty Medical Technicians in Portland, TX
• Providers in Portland, TX by specialty
• Independent Duty Medical Technicians in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.