Provider Demographics
NPI:1053157149
Name:MANCHA, LOUIS GARCIA III (LVN)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:GARCIA
Last Name:MANCHA
Suffix:III
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 BRAESVIEW APT 3711
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4874
Mailing Address - Country:US
Mailing Address - Phone:210-878-5632
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 3548
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78764-3548
Practice Address - Country:US
Practice Address - Phone:210-774-4965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320013164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse