CANCER CARE NETWORK OF SOUTH TEXAS PA (NPI# 1225064603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225064603 |
| Entity Type | Organization |
| Organization Name | CANCER CARE NETWORK OF SOUTH TEXAS PA |
| Other Organization Name | CANCER CARE CENTERS OF SOUTH TEXAS PA |
| Practice Address |
100 Ne Loop 410 Suite # 600 San Antonio TX 78216-4700 |
| Practice Telephone | 2102426541 |
| Practice Fax Number | 2102125136 |
| Mailing Telephone | 2102426541 |
| Mailing Fax Number | 2102125136 |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2011-11-03 |
| Authorized Official Name | DAVID H. GORDON (PRESIDENT) |
| Authorized Official Telephone | 2105456972 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0000X |
Internal Medicine Specialization: Hematology |
E9664 | TX | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
E9664 | TX | Allopathic & Osteopathic Physicians |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
E9664 | TX | Allopathic & Osteopathic Physicians |
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
E9664 | TX | Allopathic & Osteopathic Physicians |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
E9664 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | E9664 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
E9664 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 109514302 | 05 | |
| TX | BLUECROSS/BLUESHIELD TX | 00U40Q | 01 |
| Other Name | Type Code |
|---|---|
| Cancer Care Centers of South Texas PA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316198443 | Cancer Care Network of South Texas Pa | Internal Medicine | 1340 E Walnut St, Ste. 1348, Seguin, TX 78155-5126 | 2008-10-07 |
| 1851542971 | Cancer Care Network of South Texas Pa | Internal Medicine | 1448 E. Common St., New Braunfels, TX 78130-3162 | 2008-10-07 |
| 1841441961 | Cancer Care Network of South Texas Pa | Internal Medicine | 4411 Medical Drive, Ste. 100, San Antonio, TX 78229-3832 | 2008-10-07 |
| 1881845162 | Cancer Care Network of South Texas Pa | Internal Medicine | 606 31st St, Hondo, TX 78861-3512 | 2008-10-06 |
| 1942486964 | Cancer Care Network of South Texas Pa | Internal Medicine | 2130 N.e. Loop 410, Suite #100, San Antonio, TX 78217-4660 | 2008-01-22 |
| 1801913462 | Cancer Care Network of South Texas Pa | Internal Medicine | 1100 Mission Hills, #200, Marble Falls, TX 78654 | 2007-03-26 |
| 1619023355 | Cancer Care Network of South Texas Pa | Internal Medicine | 715 Fm 1431e, Marble Falls, TX 78654 | 2007-01-26 |
| 1841513256 | Cancer Care Network of South Texas Pa | Internal Medicine | 5000 Baptist Health Dr, Ste. 116, Schertz, TX 78154-1193 | 2010-03-12 |
| 1336390269 | Cancer Care Network of South Texas Pa | Internal Medicine | 4411 Medical Drive, Ste. 100, San Antonio, TX 78229-3832 | 2008-10-09 |
| 1982855813 | Cancer Care Network of South Texas Pa | Internal Medicine | 4411 Medical Drive, Ste. 100, San Antonio, TX 78229-3832 | 2008-10-09 |
| Street Address |
100 NE LOOP 410 SUITE # 600 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78216-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346652575 | Christus Pediatric Physician Group | Obstetrics & Gynecology | 100 Ne Loop 410, Suite 800, San Antonio, TX 78216 | 2014-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376179820 | Damiana Lea Mcmahan | Speech-Language Pathologist | 12 Inter Park Blvd, #105, San Antonio, TX 78216 | 2020-03-17 |
| 1811530967 | Hacienda Hospice, Ltd | Hospice Care, Community Based | 101 W Silver Sands Dr, San Antonio, TX 78216 | 2019-10-22 |
| 1437792876 | Eddy Sidra | Optometrist | 7400 San Pedro Avenue, Suite 486, San Antonio, TX 78216 | 2019-10-17 |
| 1083256796 | Tiffany Michelle Goericke | Physical Therapist | 502 East Ramsey, San Antonio, TX 78216 | 2019-10-14 |
| 1780246942 | Esperanza Eating Disorders Center, Pllc | Clinic/Center | 403 E. Ramsey, Suite 204, San Antonio, TX 78216 | 2019-07-08 |
| 1568938314 | Lyric Lea Lewis | Licensed Vocational Nurse | 85 Ne Interstate 410 Loop #500, San Antonio, TX 78216 | 2018-10-19 |
| 1912488206 | Rebecca Anna Poppe | Licensed Vocational Nurse | 1514 Vista Del Norte, San Antonio, TX 78216 | 2018-08-24 |
| 1205338779 | Bailee Hannah Mokry | Behavioral Analyst | 11306 Sir Winston, San Antonio, TX 78216 | 2018-03-01 |
| 1487155677 | Ojer Corbie | Behavior Technician | 11310 Sir Winston At Bld D, San Antonio, TX 78216 | 2018-02-23 |
| 1366943631 | Briana Nicole Rodriguez | Behavior Technician | 14235 Blanco Road, San Antonio, TX 78216 | 2018-02-22 |
| Find all providers in zip 78216 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881965481 | Spurs Lane Medical Associates Pa | Internal Medicine | 2 Spurs Lane, Bldg 6 Ste 100, San Antonio, TX 78240-1634 | 2012-01-13 |
| 1942486964 | Cancer Care Network of South Texas Pa | Internal Medicine | 2130 N.e. Loop 410, Suite #100, San Antonio, TX 78217-4660 | 2008-01-22 |
| 1457547135 | Ju-hsien Chao | Internal Medicine | 4450 Medical Dr Fl 1, San Antonio, TX 78229-3710 | 2007-09-17 |
| 1558403337 | Slavisa Gasic | Internal Medicine | 7355 Barlite Blvd Ste 504, San Antonio, TX 78224-1341 | 2007-02-12 |
| 1700980299 | Alexei Arkhipov | Internal Medicine | 7390 Barlite Blvd, Suite 205, San Antonio, TX 78224-1337 | 2006-09-12 |
| 1457374142 | Stephen C Cohen | Internal Medicine | 2130 N.e.loop 410, Suite #250, San Antonio, TX 78217-4660 | 2006-07-25 |
| 1285662510 | Jayasree N Rao | Internal Medicine | 202 Baltimore, San Antonio, TX 78215-1907 | 2006-06-28 |
| 1265473391 | Raul M Portillo | Internal Medicine | 1200 Brooklyn Ave Ste 115, San Antonio, TX 78212-4815 | 2006-06-09 |
| 1881632974 | Zulfaqqar M Jaffar | Internal Medicine | 8019 S New Braunfels Ste 101, San Antonio, TX 78235-1069 | 2006-06-02 |
| 1336120054 | Cancer Care Centers of South Texas | Internal Medicine | 4411 Medical Dr, Ste. 100, San Antonio, TX 78229-3832 | 2005-11-09 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78216 |
Please comment or provide details below to improve the information on CANCER CARE NETWORK OF SOUTH TEXAS PA.
| 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.