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Organization
CANCER CARE NETWORK OF SOUTH TEXAS PA
Active
Organization
CANCER CARE NETWORK OF SOUTH TEXAS PA
Active
Other names
Cancer Care Centers of South Texas PA
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID H. GORDON MD (PRESIDENT)
(210) 545-6972
Entity
Organization
Contact information
Practice address
100 NE LOOP 410, SUITE # 600, SAN ANTONIO, TX 78216-4700
(210) 242-6541
(210) 212-5136
Mailing address
100 NE LOOP 410, SUITE # 600, SAN ANTONIO, TX 78216-4700
(210) 242-6541
(210) 212-5136
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
E9664
TX
207RH0003X
Hematology & Oncology Physician
Primary
E9664
TX
207RX0202X
Medical Oncology Physician
E9664
TX
207VX0201X
Gynecologic Oncology Physician
E9664
TX
2085R0001X
Radiation Oncology Physician
E9664
TX
363AM0700X
Medical Physician Assistant
E9664
TX
363L00000X
Nurse Practitioner
E9664
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U40Q
BLUECROSS/BLUESHIELD TX
TX
05
—
109514302
—
TX
Enumeration date
06/25/2006
Last updated
11/03/2011
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