Active NPI
Stephen F Manchester, MD
- Pediatrics Physician
- San Antonio, TX
National Provider Identifier
1992794952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301052923
- Practice address
- 3851 Roger Brooke Dr
Brooke Army Medical Center
San Antonio, TX 78234-6200 - Phone
- (210) 455-9360
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301052923 | MI | Primary |
Addresses
Primary practice location
3851 Roger Brooke Dr
Brooke Army Medical Center
San Antonio, TX 78234-6200
Mailing address
3528 Marietta LN
Schertz, TX 78154-1238
Phone (210) 455-9360
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301052923 | MI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229904000000",
"number": "1992794952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3528 MARIETTA LN",
"city": "SCHERTZ",
"state": "TX",
"postal_code": "781541238",
"telephone_number": "210-455-9360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3851 ROGER BROOKE DR",
"address_2": "BROOKE ARMY MEDICAL CENTER",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782346200",
"telephone_number": "210-455-9360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCHESTER",
"first_name": "STEPHEN",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2008-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301052923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.