Organization
MEDICINE & RADIATION ONCOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURESH V DUTTA MD (MD/OWNER)
(210) 308-9999
Entity
Organization
Contact information
Practice address
1010 NW LOOP 410, SUITE 100-D, SAN ANTONIO, TX 78213-2220
(210) 308-9999
(210) 308-6262
Mailing address
1010 NW LOOP 410, SUITE 100-D, SAN ANTONIO, TX 78213-2220
(210) 308-9999
(210) 308-6262
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
L1024
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2060519-03
—
TX
Enumeration date
06/01/2009
Last updated
10/02/2015
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