Provider Demographics
NPI:1619205135
Name:MANALOOR, TIGI E (OD)
Entity Type:Individual
Prefix:
First Name:TIGI
Middle Name:E
Last Name:MANALOOR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 DALLAS PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 DALLAS PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4519
Practice Address - Country:US
Practice Address - Phone:214-500-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7218TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist