Organization
WEST LPN FORT WORTH ONCOLOGY PLLC
Active
Other names
Plaza Cancer Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF HENDERSON (PRESIDENT)
(972) 401-8726
Entity
Organization
Contact information
Practice address
1650 W ROSEDALE ST, STE 300, FORT WORTH, TX 76104-7400
(817) 338-9291
(817) 335-2817
Mailing address
1650 W ROSEDALE ST, STE 300, FORT WORTH, TX 76104-7400
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197152501
—
TX
Enumeration date
04/22/2008
Last updated
06/07/2010
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