# UT SOUTHWESTERN MONCRIEF CANCER CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Moncrief Cancer Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134443765
- **Authorized official:** DR. BRUCE A. MEYER M.D. (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (214) 645-0624

## Contact information

- **Practice address:** 400 W MAGNOLIA AVE, FORT WORTH, TX 76104-7617
- **Practice address phone:** (817) 288-9800
- **Mailing address:** 400 W MAGNOLIA AVE, FORT WORTH, TX 76104-7617
- **Mailing address phone:** (817) 288-9800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | G7980 | TX | Yes |

## Other

- **Enumeration date:** 03/25/2010
- **Last updated:** 07/11/2013