DR. IMMANUEL S. THAMBAN (NPI# 1689687238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689687238 |
| Entity Type | Individual |
| Full Name | DR. IMMANUEL S. THAMBAN |
| Credential | M.D. |
| Practice Address |
4800 Memorial Dr Waco TX 76711-1329 |
| Mailing Address |
11004 Willow Bend Dr Woodway TX 76712-8524 |
| Practice Telephone | 2542973735 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
4800 MEMORIAL DR |
| City | WACO |
| State | TX |
| Zip Code | 76711-1329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255331013 | Raymond C Lisauckis | Counselor | 4800 Memorial Dr, Va Medical Center (124-vist-w), Waco, TX 76711-1329 | 2005-07-22 |
| 1558978817 | Macey Lynn Everett | Nutritionist | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-09-29 |
| 1659980696 | Najeeah Smith | Social Worker | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-07-27 |
| 1679100309 | Sara Mariem Ramadan | Nurse Practitioner | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-03-24 |
| 1225660798 | Tiffany A Wilson | Licensed Practical Nurse | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-02-12 |
| 1972142164 | Sheri Lynn Shaw | Nurse Practitioner | 4800 Memorial Dr, Waco, TX 76711-1329 | 2020-01-05 |
| 1366085953 | Ashley P Evans | Registered Nurse | 4800 Memorial Dr, Waco, TX 76711 | 2019-10-25 |
| 1669021184 | Marian Nichole Guerrero | Nurse Practitioner | 4800 Memorial Dr, Waco, TX 76711-1329 | 2019-09-06 |
| 1003463191 | Paul Cook | Physical Therapist | 4800 Memorial Dr, Waco, TX 76711-1329 | 2019-08-22 |
| 1346892601 | Austen Anderson | Psychologist | 4800 Memorial Dr, Waco, TX 76711-1329 | 2019-07-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467090548 | Nps Care LLC | Pharmacy | 1401 S Valley Mills Drive, Beverly Hills, TX 76711 | 2019-12-19 |
| 1033684352 | Open Arms Healthcare of Texas Inc. | Clinic/Center | 1437 S. Valley Mills Drive, Waco, TX 76711 | 2018-10-13 |
| 1093178733 | Access Dental of Valley Mills Pa | Dentist | 311401 S Valley Mills Drive, Waco, TX 76711 | 2016-03-31 |
| 1134501869 | Market Place Health Care, LLC | Skilled Nursing Facility | 2430 Market Place Drive, Waco, TX 76711 | 2015-06-18 |
| 1184038507 | Visn 17 Center of Excellence for Research On Returning War Veterans | Psychiatric Hospital | 4800 Veterans Memorial Drive, 151-c, Waco, TX 76711 | 2014-06-13 |
| 1053606228 | Clenny Edward Terrell | Pharmacist | 1520 S. Valley Mills Dr., Bevely Hills, TX 76711 | 2011-06-15 |
| 1225342926 | Geoffrey May | Psychiatry & Neurology | 4800 Memorial Drive (151c), Waco, TX 76711 | 2010-08-05 |
| 1184846685 | David Charles Chandler | Specialist/Technologist | Baylor Athletic Department, 150 Bear Run, Waco, TX 76711 | 2007-05-03 |
| 1326177601 | Minh D Nguyen | Family Medicine | 4800 Memorial Dr Bldg 4, Waco, TX 76711 | 2007-03-05 |
| 1376652719 | H-e-b, Lp | Clinical Medical Laboratory | 1821 S Valley Mills Dr, Waco, TX 76711 | 2006-08-30 |
| Find all providers in zip 76711 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689670184 | Meera Amar | Internal Medicine | 333 Londonderry Drive Suite # 200, Waco, TX 76712 | 2005-06-21 |
| 1477033868 | Theresa Lynn Haddox | Internal Medicine | 333 Londonderry Dr Ste 200, Waco, TX 76712-7930 | 2018-08-15 |
| 1134470198 | Jamie Michele Olejarski | Internal Medicine | 7700 Fish Pond Rd, Waco, TX 76710-1031 | 2012-09-30 |
| 1457610933 | Elisabeth Joye Petr | Internal Medicine | 405 Londonderry Dr Ste 310, Waco, TX 76712-7922 | 2012-05-03 |
| 1760589782 | Diabetes & Endocrine Center of Central Texas Pa | Internal Medicine | 333 Londonderry Dr, Suite # 200, Waco, TX 76712-7900 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770197816 | Diabetes & Endocrinology Clinic of South Texas Pllc | Internal Medicine | 620 N Ed Carey Dr, Harlingen, TX 78550-7912 | 2020-09-05 |
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1124669866 | Endocrine Diabetes and Thyroid Specialists of Houston Pllc | Internal Medicine | 18220 Texas 249 Access Rd, Houston, TX 77070 | 2019-10-03 |
| 1053963389 | Ruba Riachy | Internal Medicine | The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555 | 2019-07-16 |
| 1093235350 | Endo Telehealth Pllc | Internal Medicine | 12518 Cutten Rd Ste B, Houston, TX 77066-1804 | 2017-06-27 |
| 1851827331 | Texas Associates of Endocrinology & Diabetes Pa | Internal Medicine | 942 Pheasant Dr, Allen, TX 75013-4891 | 2017-05-03 |
| 1366984288 | Kateryna Komarovskiy, Md, Pllc | Internal Medicine | 150 Pine Forest Dr # 103, Shenandoah, TX 77384-5302 | 2016-11-09 |
| 1265894604 | John W. Richard, Md, Pllc | Internal Medicine | 4604 Sebago Trl, Plano, TX 75093-3394 | 2016-03-24 |
| 1699140327 | Dcoa Physician Associates, Pa | Internal Medicine | 1819 Labranch, Houston, TX 77002 | 2015-12-07 |
| 1649646357 | Southeast Texas Self-management of Diabetes | Internal Medicine | 3030 North St Ste 560, Beaumont, TX 77702-1424 | 2015-08-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.