Organization
CHILDREN'S HEMATOLOGY & ONCOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG D GENTRY (NETWORK ADMIN)
(210) 616-0800
Entity
Organization
Contact information
Practice address
4499 MEDICAL DR, SUITE 260, SAN ANTONIO, TX 78229-3735
(210) 616-0800
(210) 616-0012
Mailing address
4499 MEDICAL DR, SUITE 260, SAN ANTONIO, TX 78229-3735
(210) 616-0800
(210) 616-0012
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
G6956
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1126401-02
TPI
TX
01
—
80X050
BC&BS
TX
Enumeration date
05/15/2008
Last updated
05/15/2008
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