Individual
DR. VICTOR WILLIAM HORADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4700 N GALLOWAY AVE, MESQUITE, TX 75150-1516
(972) 686-6411
(972) 686-0594
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
E6425
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135707101
—
TX
05
—
135707102
—
TX
05
—
135707103
—
TX
05
—
135707104
—
TX
05
—
135707105
—
TX
05
—
135707109
—
TX
05
—
135707111
—
TX
01
—
8R1467
BLUE CROSS OF TEXAS
TX
Enumeration date
06/12/2006
Last updated
03/08/2011
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