Provider Demographics
NPI:1861877813
Name:MIANO, EMANUEL MUGU (PT DPT, NCS)
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:MUGU
Last Name:MIANO
Suffix:
Gender:M
Credentials:PT DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 CARTWRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2443
Mailing Address - Country:US
Mailing Address - Phone:346-341-7307
Mailing Address - Fax:
Practice Address - Street 1:2121 RICHMOND AVE # 324
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098
Practice Address - Country:US
Practice Address - Phone:832-303-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1243190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist