MR. RAYMOND PAMPOLINA MANAHAN (NPI# 1417142431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417142431 |
| Entity Type | Individual |
| Full Name | MR. RAYMOND PAMPOLINA MANAHAN |
| Credential | IDC |
| Practice Address |
905 La Mirada Portland TX 78374-4130 |
| Practice Telephone | 3617764569 |
| Mailing Telephone | 3617764569 |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
905 LA MIRADA |
| City | PORTLAND |
| State | TX |
| Zip Code | 78374-4130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700407350 | Emad Banoub | Pharmacist | 1105 Hyw 181, Portland, TX 78374 | 2020-05-05 |
| 1184256893 | Rebecca Lovins | Behavior Technician | 304, Frio Dr, Portland, TX 78374 | 2020-02-11 |
| 1760962997 | Kimberly Beal | Licensed Vocational Nurse | 201 Sabine St, Portland, TX 78374 | 2018-08-16 |
| 1134577836 | Christopher Tipton | Specialist/Technologist | 4800 Wildcat Dr., Portland, TX 78374 | 2016-06-03 |
| 1134592629 | Coastal Bend Physicians Pllc | Clinic/Center | 1860 Us Highway 181, Suite C, Portland, TX 78374 | 2015-11-05 |
| 1093191397 | Coastal Er IIi, LLC | Clinic/Center | 1860 Highway 181 Frontage Road, Ste C, Portland, TX 78374 | 2015-08-10 |
| 1376942466 | Allen Portland Dentistry Associates Pllc | Dentist | 101 Cox Dr., Portland, TX 78374 | 2014-08-14 |
| 1699188284 | Leola Brumley | Speech-Language Pathologist | 2002 Matagorda Dr., Portland, TX 78374 | 2014-06-11 |
| 1780937607 | Erika Kristine De La Garza | Nurse Practitioner | 1702 Hwy. 181 North, Portland, TX 78374 | 2012-10-16 |
| 1538355219 | Andrew Marcus Rosendahl | Physician Assistant | 1912 Falcon Drive, Portland, TX 78374 | 2007-09-17 |
| Find all providers in zip 78374 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366676462 | Bobbi Gabriele Kennedy | Military Health Care Provider | 6801 Ne Cornfoot Road, Portland, OR 97218 | 2009-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453145 | Ian Frogley | Military Health Care Provider | Jbsa 2230 Hughes Ave, San Antonio, TX 78236-8404 | 2020-10-06 |
| 1861099939 | Andrew Goebel | Military Health Care Provider | 1800 Truemper St, San Antonio, TX 78236-5510 | 2020-10-02 |
| 1790382844 | Kyle Schachsieck | Military Health Care Provider | 2800 Winfield Scott Rd Ste 347, Fort Sam Houston, TX 78234-7662 | 2020-10-01 |
| 1861018178 | John C Gallik | Military Health Care Provider | 3176 Corporal Johnson Road, Jbsa Fort Sam Houston, TX 33809 | 2020-06-23 |
| 1376169086 | Colton Wayne Dickens | Military Health Care Provider | 5415 N Foster Rd Apt 8306, San Antonio, TX 78244-2405 | 2020-06-18 |
| 1750924692 | Michelle Lynn Hernando | Military Health Care Provider | 109 Kentucky St, Dyess Afb, TX 79607-1007 | 2019-10-23 |
| 1598315061 | Matthew Scott Floores | Military Health Care Provider | 7303 S Ute Trl, Austin, TX 78729-7756 | 2019-09-17 |
| 1427529650 | Riley Pearl Solomon | Military Health Care Provider | 6419 N Vandiver Rd Apt 2203, Alamo Heights, TX 78209-4484 | 2018-12-16 |
| 1588135719 | Alejandro Daniel Perez | Military Health Care Provider | Wilderness Trl & Camp Bullis, San Antonio, TX 78257 | 2018-12-16 |
| 1861969271 | Jose A Sanchez | Military Health Care Provider | 15425 Bobwhite Quail, San Antonio, TX 78253-6621 | 2018-10-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.