Individual
DR. EZHILARASI MANICKAVASAGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
2112 SW H K DODGEN LOOP STE 110, TEMPLE, TX 76504-7011
(877) 800-5722
Mailing address
2423 WILLIAMS DR STE 107, GEORGETOWN, TX 78628-3269
(877) 800-5722
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
S2837
TX
Other
Enumeration date
07/15/2008
Last updated
07/16/2025
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