Organization Active NPI

Carlos Manrique de Lara Mdpa

  • Ophthalmology Physician
  • Edinburg, TX
National Provider Identifier
1770558447
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CARLOS MANRIQUE DE LARA MDPA
Practice address
2518 W Trenton Rd
Edinburg, TX 78539-8070
Phone
(956) 661-9000
Fax
(956) 686-7833
NPI assigned
Feb 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Dr. Carlos Manrique de Lara, MDNPI 1699740324
Title
Medical Director
Phone
(956) 661-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2518 W Trenton Rd
Edinburg, TX 78539-8070

Mailing address

2518 W Trenton Rd
Edinburg, TX 78539-8070
Phone (956) 661-9000

Other identifiers 1

IdentifierTypeStateIssuer
173356002MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610000078 TX Part B Supplier - Clinic/Group Practice 2466435540 Receives reassigned benefits from 11 practitioners
Practice locations: Edinburg, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2055713Carlos Manrique de Lara MD PA2518 W Trenton Road, Edinburg, TX 78539Certificate of waiverMar 14, 2027

National Provider Directory

National Provider Directory

Locations

2502 Cornerstone Blvd
Edinburg, TX 78539
Phone (956) 661-9000

5505 S Expressway 77
Ste 105
Harlingen, TX 78550

15900 La Cantera Pkwy
Ste 20115
San Antonio, TX 78256
Phone (210) 354-2020

15900 La Cantera Pkwy
Ste 20215
San Antonio, TX 78256
Phone (210) 354-2020

21019 US Highway 281 N
San Antonio, TX 78258

9595 Six Pines Dr
The Woodlands, TX 77380
Phone (281) 292-3962

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1770558447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 W TRENTON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398070",
            "telephone_number": "956-661-9000",
            "fax_number": "956-686-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 W TRENTON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398070",
            "telephone_number": "956-661-9000",
            "fax_number": "956-686-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS MANRIQUE DE LARA MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "MANRIQUE DE LARA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "956-661-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173356002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.