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Individual

DR. EPHRAIM ISAAC THALLER

Active
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Individual

DR. EPHRAIM ISAAC THALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
L4144
TX
207KA0200X
Allergy Physician
L4144
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00712N
MEDICARE GROUP PTAN
TX
01
—
151825100
FIRST CARE
—
05
—
180355301
—
TX
01
—
8V9670
BCBS
—
01
—
P00428353
RAILROAD MEDICARE
—
Enumeration date
05/23/2006
Last updated
12/27/2021
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