| Manor Clinical Services LLC | |
|
1259 Fm 1463 Rd Ste 700 Katy TX 77494-5480 | |
| (346) 609-1418 | |
| Not Available |
| Full Name | Manor Clinical Services LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1259 Fm 1463 Rd Ste 700, Katy, Texas |
| Authorized Official Name and Position | Vishal Patel (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3166091418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manor Clinical Services LLC 26605 Cook Field Rd Ste 410 Katy TX 77494-8644 Ph: (346) 609-1418 | Manor Clinical Services LLC 1259 Fm 1463 Rd Ste 700 Katy TX 77494-5480 Ph: (346) 609-1418 |
| NPI Number | 1275373300 |
|---|---|
| Provider Enumeration Date | 05/28/2024 |
| Last Update Date | 10/07/2026 |
| Certification Date | 10/07/2026 |
| Medicare PECOS PAC ID | 1254879109 |
|---|---|
| Medicare Enrollment ID | O20240810000180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275373300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| 363LF0000X | Nurse Practitioner - Family | () | Secondary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | () | Secondary |
| Provider Name | Jason Solita De Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033730080 PECOS PAC ID: 3173947652 Enrollment ID: I20200716001589 |
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