Organization
CANCER CARE NETWORK OF SOUTH TEXAS PA
Active
Other names
Office - Medical Drive
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER M LYONS MD (PRESIDENT)
(210) 595-5300
Entity
Organization
Contact information
Practice address
4411 MEDICAL DRIVE, STE. 100, SAN ANTONIO, TX 78229-3832
(210) 595-5300
(210) 595-5301
Mailing address
4411 MEDICAL DRIVE, STE. 100, SAN ANTONIO, TX 78229-3832
(210) 595-5300
(210) 595-5301
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
Primary
—
—
207RX0202X
Medical Oncology Physician
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U40Q
BCBS OF TX
TX
05
—
109514302
—
TX
Enumeration date
10/09/2008
Last updated
07/13/2011
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