Organization
NORTHWEST RADIOTHERAPY ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA DAVILA-PRUNEDA (MANAGER)
(713) 467-5700
Entity
Organization
Contact information
Practice address
13700 MEDICAL COMPLEX DR, TOMBALL, TX 77375-6554
(713) 467-5700
(713) 467-5702
Mailing address
PO BOX 73152, HOUSTON, TX 77273-3152
(713) 467-5700
(713) 467-5702
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N45X
BLUE CROSS
TX
05
—
084191801
—
TX
Enumeration date
07/12/2005
Last updated
08/31/2012
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