Organization
EAST TEXAS MEDICAL CENTER CANCER INSTITUTE
Active
Other names
ETMC CANCER INSTITUTE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BYRON HALE (CFO)
(903) 535-6215
Entity
Organization
Contact information
Practice address
721 CLINIC DR, TYLER, TX 75701-2043
(903) 595-5550
Mailing address
PO BOX 7908, TYLER, TX 75711-7908
(903) 531-2371
(903) 531-2337
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00SN36
BCBS OF TEXAS
TX
05
—
085049701
—
TX
Enumeration date
08/17/2006
Last updated
08/06/2009
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