Provider Demographics
NPI:1235950304
Name:MANER, VIVIAN (PHD)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:MANER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6826 DE PALMA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-3626
Mailing Address - Country:US
Mailing Address - Phone:210-710-4788
Mailing Address - Fax:
Practice Address - Street 1:6826 DE PALMA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-3626
Practice Address - Country:US
Practice Address - Phone:210-710-4788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8856182171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor