Active NPI
Ebonique Manning
- Bus
- Grand Prairie, TX
National Provider Identifier
1992231286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Bus
- License
- 17169013
- Practice address
- 2445 Miller St
Grand Prairie, TX 75051-5553 - Phone
- (254) 541-8099
- NPI assigned
- May 4, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Bus | 347B00000X | 17169013 | TX | Primary |
Addresses
Primary practice location
2445 Miller St
Grand Prairie, TX 75051-5553
Mailing address
2445 Miller St
Grand Prairie, TX 75051-5553
Phone (254) 541-8099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17169013 | TX | MD | Bus |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1992231286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2445 MILLER ST",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750515553",
"telephone_number": "254-541-8099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2445 MILLER ST",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750515553",
"telephone_number": "254-541-8099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNING",
"first_name": "EBONIQUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-04",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "347B00000X",
"taxonomy_group": "",
"desc": "Bus",
"state": "TX",
"license": "17169013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.