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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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