Organization
BRAZOS VALLEY CANCER CLINICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJ CHERUKU MD (OWNER)
(979) 830-0700
Entity
Organization
Contact information
Practice address
605 MEDICAL CT, SUITE 202, BRENHAM, TX 77833-5404
(979) 830-0700
(979) 251-9996
Mailing address
625 MEDICAL COURT, SUITE 202, BRENHAM, TX 77833
(979) 830-0700
(979) 251-9996
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
J0459
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00X743
MEDICARE
TX
Enumeration date
12/29/2006
Last updated
11/29/2007
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