Individual
JEEVAN THAMBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1901 VETERANS MEMORIAL DR, TEMPLE, TX 76504-7451
(254) 778-4811
Mailing address
14402 W BELLFORT ST APT 1135, SUGAR LAND, TX 77498-1834
(254) 495-0241
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP141333
TX
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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