Organization
UT SOUTHWESTERN MONCRIEF CANCER CENTER
Active
Other names
Moncrief Cancer Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE A. MEYER M.D. (EXECUTIVE VICE PRESIDENT)
(214) 645-0624
Entity
Organization
Contact information
Practice address
400 W MAGNOLIA AVE, FORT WORTH, TX 76104-7617
(817) 288-9800
Mailing address
400 W MAGNOLIA AVE, FORT WORTH, TX 76104-7617
(817) 288-9800
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G7980
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109397302
—
TX
Enumeration date
03/25/2010
Last updated
07/11/2013
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