Individual
DR. IMMANUEL S. THAMBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4800 MEMORIAL DR, WACO, TX 76711-1329
(254) 297-3735
Mailing address
11004 WILLOW BEND DR, WOODWAY, TX 76712-8524
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
IL
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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