Individual provider Active NPI

Paul J Manfre, D.C.

  • Chiropractor
  • Carrollton, TX
National Provider Identifier
1669406310
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7164 Issued in TX
Practice address
3032 E. Hebron Pkwy., Ste. 103
Carrollton, TX 75010
Phone
(972) 416-2000
Fax
(972) 394-9959
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7164 TX Primary

Addresses

Primary practice location

3032 E. Hebron Pkwy., Ste. 103
Carrollton, TX 75010

Mailing address

PO Box 116895
Carrollton, TX 75011-6895
Phone (972) 416-2000

Other identifiers 1

IdentifierTypeStateIssuer
001960601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140121000061 TX Practitioner - Chiropractic 7012145063 Practice locations: Carrollton, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3032 E Hebron Pkwy
Carrollton, TX 75010-4465

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7164TXMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1669406310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116895",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750116895",
            "telephone_number": "972-416-2000",
            "fax_number": "972-394-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3032 E. HEBRON PKWY., STE. 103",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "972-416-2000",
            "fax_number": "972-394-9959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANFRE",
        "first_name": "PAUL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "7164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001960601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.