Organization
ONCOLOGY-HEMATOLOGY CONSULTANTS PA
Active
Other names
The Center for Cancer and Blood Disorders
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY RUSSO (EXECUTIVE DIRECTOR)
(817) 333-0175
Entity
Organization
Contact information
Practice address
920 SANTA FE DR, WEATHERFORD, TX 76086-5864
(817) 596-0637
Mailing address
PO BOX 164009, FORT WORTH, TX 76161-4009
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093916-02
—
TX
Enumeration date
05/19/2006
Last updated
10/28/2020
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