DR. EMMANUEL CEMPRON MANTILLA JR. (NPI# 1477757730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477757730 |
| Entity Type | Individual |
| Full Name | DR. EMMANUEL CEMPRON MANTILLA JR. |
| Credential | DO |
| Practice Address |
1400 S Main St Ste 502 Fort Worth TX 76104-4909 |
| Mailing Address |
200 West Magnolia Ave, Suite 201 Acclaim Physician Group Fort Worth TX 76104 |
| Practice Telephone | 8177028400 |
| Practice Fax Number | 8179273982 |
| Mailing Telephone | 8177022385 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2019-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
R5771 | TX | Allopathic & Osteopathic Physicians |
| N | 225X00000X | Occupational Therapist | OT6189 | OH | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2201 Inwood Rd, Dallas, TX 753907137 | 2146454673 | |
| 7233 Whipple Ave Nw, North Canton, OH 447207137 | 3304988200 |
| Street Address |
1400 S MAIN ST STE 502 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073629986 | Raza A Jafry | Internal Medicine | 1400 S Main St Ste 502, Fort Worth, TX 76104-4909 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760836548 | Neurospine Monitoring, Pllc | Psychiatry & Neurology | 8553 N Beach St # 388, Fort Worth, TX 76244-4919 | 2016-04-19 |
| 1851737985 | Fatoumata Marie Sakho | Psychiatry & Neurology | 6800 Harris Pkwy Ste 100, Fort Worth, TX 76132-4247 | 2013-05-15 |
| 1205141041 | Babak Attaran Rezaei | Psychiatry & Neurology | 3354 Western Center Blvd, Ste 160, Fort Worth, TX 76137-1938 | 2010-08-17 |
| 1154641215 | Akemi Watkins | Psychiatry & Neurology | 901 7th Ave Ste 2200, Fort Worth, TX 76104-2722 | 2010-06-10 |
| 1588982664 | Nirav Shah | Psychiatry & Neurology | 4525 Heritage Trace Pkwy Ste 117, Fort Worth, TX 76244-8910 | 2010-05-13 |
| 1598926479 | Edward L. Kramer, D.o., P.a. | Psychiatry & Neurology | 4916 Camp Bowie Blvd, 108, Fort Worth, TX 76107-4196 | 2008-06-23 |
| 1134305899 | Kirit C Shah P C | Psychiatry & Neurology | 1550 W Rosedale St Ste 306, Fort Worth, TX 76104-7407 | 2008-01-11 |
| 1699986943 | Lavanya Latha Nagineni | Psychiatry & Neurology | 6800 Harris Pkwy, Suite 100, Fort Worth, TX 76132-4240 | 2007-05-25 |
| 1386716090 | Kirit C Shah | Psychiatry & Neurology | 800 8th Ave Ste 636, Fort Worth, TX 76104-2617 | 2006-11-15 |
| 1558449603 | Victoria K. Nwosu | Psychiatry & Neurology | 1307 Eighth Ave, 408, Fort Worth, TX 76104-4140 | 2006-11-02 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on DR. EMMANUEL CEMPRON MANTILLA JR..
| 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.