Organization
CANCER CARE NETWORK OF SOUTH TEXAS PA
Active
Parent organization
CANCER CARE NETWORK OF SOUTH TEXAS, P.A.
Other names
Northeast Cancer Center/SA Tumor & Blood
Organization subpart
Yes
Provider details
NPI number
Legal business name
CANCER CARE NETWORK OF SOUTH TEXAS, P.A.
Authorized official
DR. DAVID H GORDON M.D. (PRESIDENT)
(210) 656-7177
Entity
Organization
Contact information
Practice address
2130 N.E. LOOP 410, SUITE #100, SAN ANTONIO, TX 78217-4660
(210) 656-7177
(210) 656-3687
Mailing address
100 NE LOOP 410, SUITE #600, SAN ANTONIO, TX 78216-4700
(210) 242-6541
(210) 212-5136
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
01/22/2008
Last updated
10/27/2011
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