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Organization
CEDAR PARK ONCOLOGY CLINIC
Active
Organization
CEDAR PARK ONCOLOGY CLINIC
Active
Parent organization
TEMPLE CANCER CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEMPLE CANCER CLINIC
Authorized official
DR. MANI SUBRAMANIAN M.D. (OWNER)
(254) 526-5353
Entity
Organization
Contact information
Practice address
921 W NEW HOPE DR, SUITE 702, CEDAR PARK, TX 78613-6778
(512) 986-4036
(512) 986-4596
Mailing address
2207 S CLEAR CREEK RD, SUITE 302, KILLEEN, TX 76549-4132
(254) 526-5353
(254) 554-5298
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G4724
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8S4240
BCBS TX PROVIDER NUMBER
TX
Enumeration date
10/23/2008
Last updated
10/23/2008
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