Organization Active NPI

Advance Radiation Oncology Care PLLC

  • Radiation Oncology Physician
  • Sugar Land, TX
National Provider Identifier
1104390897
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
ADVANCE RADIATION ONCOLOGY CARE PLLC
Practice address
2245 Texas Dr Ste 300
Sugar Land, TX 77479-1468
Phone
(281) 566-2527
Fax
(281) 201-4151
NPI assigned
Jan 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bailey Bryans
Title
Business Manager
Phone
(281) 566-2527

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

2245 Texas Dr Ste 300
Sugar Land, TX 77479-1468

Mailing address

2245 Texas Dr Ste 300
Sugar Land, TX 77479-1468
Phone (281) 566-2527

Other practice location 1

21216 Northwest Fwy Ste 560
Cypress, TX 77429-4697
Phone (281) 566-2527

Other identifiers 1

IdentifierTypeStateIssuer
3947723-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190129003772 TX Part B Supplier - Clinic/Group Practice 9931446945 Receives reassigned benefits from 1 practitioner
Practice locations: Cypress, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1104390897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 TEXAS DR STE 300",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774791468",
            "telephone_number": "281-566-2527",
            "fax_number": "281-201-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 TEXAS DR STE 300",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774791468",
            "telephone_number": "281-566-2527",
            "fax_number": "281-201-4151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21216 Northwest Fwy Ste 560",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "TX",
            "postal_code": "774294697",
            "country_code": "US",
            "telephone_number": "281-566-2527",
            "fax_number": "281-201-4151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCE RADIATION ONCOLOGY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-15",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "BRYANS",
        "authorized_official_first_name": "BAILEY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "281-566-2527"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3947723-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.