Organization
DALLAS ONCOLOGY CONSULTANTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANTIAGO CALDERON (BILLING BUSINESS MANAGER)
(972) 283-2389
Entity
Organization
Contact information
Practice address
2800 E BROAD ST, SUITE 212, MANSFIELD, TX 76063-6409
(682) 518-8444
(682) 518-8846
Mailing address
310 E HIGHWAY 67, DUNCANVILLE, TX 75137-4159
(972) 283-2389
(972) 283-2473
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U90U
BLUE CROSS BLUE SHIELD
TX
05
—
190974901
—
TX
Enumeration date
07/11/2008
Last updated
11/11/2010
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