Organization
CANCER CARE NETWORK OF SOUTH TEXAS PA
Active
Other names
Radiation-San Antonio Tumor&Blood
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID H GORDON M.D. (PRESIDENT)
(210) 545-6972
Entity
Organization
Contact information
Practice address
1200 BROOKLYN AVE, SUITE#115, SAN ANTONIO, TX 78212-4803
(210) 224-6531
(210) 226-0402
Mailing address
1200 BROOKLYN AVE, SUITE#115, SAN ANTONIO, TX 78212-4803
(210) 224-6531
(210) 226-0402
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U40Q
BLUECROSS/BLUESHIELD TX
TX
05
—
109514302
—
TX
Enumeration date
09/01/2006
Last updated
05/27/2010
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