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Organization
ST. JUDE INTERNATIONAL CANCER ASSOCIATES, P.A.
Active
Organization
ST. JUDE INTERNATIONAL CANCER ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMBROSE ABOUD MD (PRESIDENT)
(915) 544-8844
Entity
Organization
Contact information
Practice address
1900 N OREGON ST, SUITE 500, EL PASO, TX 79902-3351
(915) 544-8844
(915) 544-7650
Mailing address
5959 GATEWAY BLVD W, SUITE 120, EL PASO, TX 79925-3331
(915) 779-1716
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F9119
TX
207RH0003X
Hematology & Oncology Physician
F9119
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081412102
—
TX
01
—
45D0509362
CLIA ID NUMBER
TX
Enumeration date
09/30/2005
Last updated
02/03/2015
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