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TEMPLE CANCER CLINIC PA NPI 1629001045


NPI Information

NPI: 1629001045
Provider Name: TEMPLE CANCER CLINIC, PA
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
2207 S CLEAR CREEK RD
SUITE 302
KILLEEN, TX
ZIP 76549
Phone: (254) 526-5353
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TEMPLE CANCER CLINIC, PA is a hematology and oncology internal medicine in Killeen, TX. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. TEMPLE CANCER CLINIC, PA NPI is 1629001045. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2207 S CLEAR CREEK RD
SUITE 302
KILLEEN, TX
ZIP 76549-132
Phone: (254) 526-5353
Fax: (254) 554-5298

The provider's authorized official is Mani Subramanian .
The authorized official title is Dr Owner and has the following contact phone number (254) 526-5353.

The enumeration date for this NPI number is 7/9/2006 and was last updated on 10/15/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RH0003XInternal MedicineHematology & OncologyG4724TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18S4240OTHERTEXASBCBSTX PROVIDER NUMBER
200271ZMEDICARE PINTEXAS
3D69160MEDICARE UPINTEXAS
4180220901MEDICAIDTEXAS
5180221701MEDICAIDTEXAS
61281644-01MEDICAIDTEXAS
78F0801MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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