Organization
SCOTT & WHITE CENTER FOR CANCER PREVENTION AND CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE CANTU (ASSOC VICE PRESIDENT, RCO)
(254) 215-9719
Entity
Organization
Contact information
Practice address
2207 S CLEAR CREEK RD, SUITE 101, KILLEEN, TX 76549-4132
(254) 200-3200
Mailing address
PO BOX 847408, DALLAS, TX 75284-7408
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C307
BLUE SHIELD
TX
05
—
1496267-01
—
TX
05
—
1496267-02
—
TX
Enumeration date
04/10/2006
Last updated
12/27/2012
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