Provider Demographics
NPI:1689671554
Name:TAMBOLI, SANOBER M (MD)
Entity Type:Individual
Prefix:DR
First Name:SANOBER
Middle Name:M
Last Name:TAMBOLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:23222 KINGSLAND BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3033
Mailing Address - Country:US
Mailing Address - Phone:281-693-0084
Mailing Address - Fax:281-693-0093
Practice Address - Street 1:23222 KINGSLAND BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3033
Practice Address - Country:US
Practice Address - Phone:281-693-0084
Practice Address - Fax:281-693-0093
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ9825207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G21430Medicare UPIN
TX86640JMedicare PIN