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Organization
TEMPLE CANCER CLINIC, PA
Active
Organization
TEMPLE CANCER CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANI SUBRAMANIAN (DR OWNER)
(254) 526-5353
Entity
Organization
Contact information
Practice address
2207 S CLEAR CREEK RD, SUITE 302, KILLEEN, TX 76549-4132
(254) 526-5353
(254) 554-5298
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
05
—
1281644-01
—
TX
05
—
180220901
—
TX
05
—
180221701
—
TX
01
—
8S4240
BCBSTX PROVIDER NUMBER
TX
Enumeration date
07/09/2006
Last updated
10/15/2007
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