ALYSSA NICOLE MANGAN-RETA
Physical Medicine & Rehabilitation

Address: 1130 Broadway St Apt 452, San Antonio, TX 78215-1469

ALYSSA NICOLE MANGAN-RETA (NPI# 1891376596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891376596
Entity Type Individual
Full Name ALYSSA NICOLE MANGAN-RETA
Gender Female
Credential DO
Practice Address 1130 Broadway St Apt 452
San Antonio
TX 78215-1469
Practice Telephone 2102793466
Mailing Address 7703 Floyd Curl Dr
San Antonio
TX 78229-3901
Mailing Telephone 2105675300
Certification Date 2021-04-13
Enumeration Date 2021-04-15
Last Update Date 2021-04-15
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
N 208100000X Physical Medicine & Rehabilitation BP10074275 TX Allopathic & Osteopathic Physicians
Y 390200000X Student in an Organized Health Care Education/Training Program TX Student, Health Care

Office Location

Street Address 1130 BROADWAY ST APT 452
City SAN ANTONIO
State TX
Zip Code 78215-1469

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1053914200 Lauren Elizabeth Mathes Physician Assistant One Lexington Building, 215 East Quincy Street, Suite 604, San Antonio, TX 78215 2020-11-19
1710487780 Webster Street Dental Pllc · Elevate Dental Clinic/Center - Dental 311 E Jones Ave, San Antonio, TX 78215 2018-02-16
1194207415 Emily Beth Young Registered Nurse 245 Post Ave Apt 3, San Antonio, TX 78215-1041 2018-09-04
1093310930 Meagan Ashtin Zavala Pharmacist 1915 Broadway St Ste 101, San Antonio, TX 78215-1133 2020-11-30
1154985646 Sherry Webber Nurse Practitioner - Family 2520 Broadway St Ste 100, San Antonio, TX 78215-1148 2019-04-30
1013550631 Lindsay Kaye Morgan Byers Nurse Practitioner - Family 503 Avenue A Apt 1438, San Antonio, TX 78215-1278 2019-10-27
1336746007 Lina Bottomley Counselor - Addiction (Substance Use Disorder) 814 Camden St, San Antonio, TX 78215-1445 2020-10-06
1023677614 Gail Theresa Bergen X Dental Assistant 427 9th St, San Antonio, TX 78215-1528 2019-06-07
1023508033 Hazel V Pascual-Gonzales Nurse Practitioner - Family 621 Camden St Ste 202, San Antonio, TX 78215-1644 2018-05-15
1669080966 Kimberly Luu Physical Therapist 710 Augusta, San Antonio, TX 78215-1904 2020-07-22
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Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861073694 Shawnee Wallace Student in an Organized Health Care Education/Training Program 100 N Santa Rosa, San Antonio, TX 78207-3205 2021-04-14
1679153654 Genevieve Mariah Rebon · Genevieve Mariah Martin Student in an Organized Health Care Education/Training Program 4301 Broadway # St121, San Antonio, TX 78209-6318 2021-04-13
1235719303 Lizette Alejandra Lugo Student in an Organized Health Care Education/Training Program 9710 Via Belcara Apt 102, San Antonio, TX 78240-4491 2021-04-12
1376123794 Alejandro Sanchez Student in an Organized Health Care Education/Training Program 7703 Floyd Curl Dr Mc 7792, Dept of Psychiatry Residency Program, San Antonio, TX 78229 2021-04-09
1508445545 Ethan Hinds IIi Student in an Organized Health Care Education/Training Program 7703 Floyd Curl Dr # Mc, San Antonio, TX 78229-3901 2021-04-06
1508445909 Erika Durant Student in an Organized Health Care Education/Training Program 15806 Lomita Springs Dr, San Antonio, TX 78247-5607 2021-04-05
1679151716 Kaylyn Stork Student in an Organized Health Care Education/Training Program 13000 Vista Del Norte Apt 236, San Antonio, TX 78216-8044 2021-03-30
1568040905 Albert Viesca · Albert Viesca Student in an Organized Health Care Education/Training Program 23814 Tumbleweed Ln, San Antonio, TX 78264-9237 2021-03-29
1043898547 Austin Wharton Gay Student in an Organized Health Care Education/Training Program 7703 Floyd Curl Dr # 7736, San Antonio, TX 78229-3901 2021-03-29
1053999441 Alvaro Rene Saenz Student in an Organized Health Care Education/Training Program 703 E Hildebrand Ave, San Antonio, TX 78212-2535 2021-03-29
Find all providers in SAN ANTONIO

Competitor

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City SAN ANTONIO
Zip Code 78215

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Dataset Information

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.