Thaller, Ephraim Isaac
Thaller, Ephraim Isaac is an individual health care provider with primary practice located at 333 Londonderry Dr Suite 100, Waco TX 76712-7900. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy, Allopathic & Osteopathic Physicians / Allergy & Immunology. Allopathic & Osteopathic Physicians / Allergy & Immunology is his primary health care specialty. Thaller, Ephraim Isaac can be contacted via phone (254) 751-1144.Contact Information
Primary practice address
333 Londonderry Dr Suite 100
Waco TX 76712-7900
Phone: (254) 751-1144
Fax: (254) 751-1185
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy | 207KA0200X | L4144 | Texas |
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | L4144 | Texas |
Profile Details
| NPI number | 1245285022 |
|---|---|
| LBN Legal business name | Thaller, Ephraim Isaac |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Dec 27th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245285022 | NPPES |
| Texas | MEDICAID | 180355301 | |
| Texas | Other | 00712N | |
| Texas | Other | P00428353 | |
| Texas | Other | 151825100 | |
| Texas | Other | 8V9670 |
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