Ronald E. Manicom, MD, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

C9055 Issued in TX

Legal business name

RONALD E. MANICOM, MD, PA

Practice address

1200 Lakeway Dr
Suite 8
Lakeway, TX 78734-4474

Phone

(512) 248-9000

Fax

(512) 248-9012

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Angela Fouss

Title

Office Manager

Phone

(512) 248-9000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1891820106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 LAKEWAY DR",
            "address_2": "SUITE 8",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344474",
            "telephone_number": "512-248-9000",
            "fax_number": "512-248-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LAKEWAY DR",
            "address_2": "SUITE 8",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344474",
            "telephone_number": "512-248-9000",
            "fax_number": "512-248-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD E. MANICOM, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "FOUSS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "512-248-9000"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "C9055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramiro Jose Rodriguez III
• Magaly Rojas Sanchez, RN
• Matthew T. Romberg, MD
• Corey Steven Romero, DDS
• Ronald Devere, MD PA
• Autumn Rounsaville
• Jimmy L Rowland IV, DPT
• Kristen Laurel Ruehlman, PHARMD
• Harold Wayne Rux, DDS
• S & a Golshani, PLLC

• All providers in Lakeway, TX
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.