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Individual

DR. MANI SUBRAMANIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

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
1802209-01
TX
05
1802217-01
TX
01
8S4240
BCBSTX PROVIDER NUMBER
TX
Enumeration date
01/29/2007
Last updated
12/30/2014
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