Individual
DR. VIVIANE MAMLOK
Active
Individual
DR. VIVIANE MAMLOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
H0597
TX
207ZP0213X
Pediatric Pathology Physician
Primary
H0597
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52453
PRESBYTERIAN COMMERCIAL
NM
05
—
52453
—
NM
01
—
80816Z
HMO BLUE
TX
01
—
82P200
BLUE CROSS & BLUE SHIELD
TX
01
—
A120
TRIWEST
—
05
—
J6446
—
NM
Enumeration date
05/24/2005
Last updated
07/12/2007
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