Organization
CANCER CARE NETWORK OF SOUTH TEXAS PA
Active
Other names
Northeast Methodist-S.A.Tumor&Blood
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID H GORDON M.D. (PRESIDENT)
(210) 381-6533
Entity
Organization
Contact information
Practice address
12709 TOEPPERWEIN RD, SUITE 306, LIVE OAK, TX 78233-3258
(210) 381-6533
Mailing address
12709 TOEPPERWEIN RD, SUITE 306, LIVE OAK, TX 78233-3258
(210) 381-6533
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U40Q
BLUECROSS/BLUESHIELD TX
TX
05
—
109514302
—
TX
Enumeration date
06/03/2008
Last updated
05/26/2010
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