Organization
CANCER CARE NETWORK OF SOUTH TEXAS PA
Active
Other names
Marble Falls Office-S.A.Tumor & Blood Clinic
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
715 FM 1431E, MARBLE FALLS, TX 78654
(830) 693-0555
Mailing address
715 FM 1431E, MARBLE FALLS, TX 78654
(830) 693-0555
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
E9664
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U40Q
BLUECROSS BLUESHIELD TX
TX
05
—
109514302
—
TX
Enumeration date
01/26/2007
Last updated
05/26/2010
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