Organization
CANCER CARE NETWORK OF SOUTH TEXAS PA
Active
Other names
NECancer Center Radiology SATBC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID H GORDON MD (PRESIDENT)
(210) 656-7177
Entity
Organization
Contact information
Practice address
2130 NE LOOP 410, SUITE 100, SAN ANTONIO, TX 78217-4659
(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
2085R0001X
Radiation Oncology Physician
Primary
—
—
2085R0203X
Therapeutic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U40Q
BLUECROSS/BLUESHIELD TX.
TX
05
—
109514302
—
TX
Enumeration date
06/03/2008
Last updated
10/27/2011
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