Individual
NIMMI VARGHESE MANALOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.B.B.S.
Contact information
Practice address
19238 STONEHUE, SAN ANTONIO, TX 78258-3447
(210) 494-2223
(210) 941-0142
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
11014722A
IN
208000000X
Pediatrics Physician
Primary
U0157
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201186330
—
IN
Enumeration date
04/07/2009
Last updated
10/06/2022
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