# CEDAR PARK ONCOLOGY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TEMPLE CANCER CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134372030
- **Legal business name:** TEMPLE CANCER CLINIC
- **Authorized official:** DR. MANI SUBRAMANIAN M.D. (OWNER)
- **Authorized official phone:** (254) 526-5353

## Contact information

- **Practice address:** 921 W NEW HOPE DR, SUITE 702, CEDAR PARK, TX 78613-6778
- **Practice address phone:** (512) 986-4036
- **Practice address fax:** (512) 986-4596
- **Mailing address:** 2207 S CLEAR CREEK RD, SUITE 302, KILLEEN, TX 76549-4132
- **Mailing address phone:** (254) 526-5353
- **Mailing address fax:** (254) 554-5298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | G4724 | TX | Yes |

## Other

- **Enumeration date:** 10/23/2008
- **Last updated:** 10/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 8S4240 | BCBS TX PROVIDER NUMBER | TX |