NPIMap

Organization Active NPI

Cancer Care Network of South Texas PA

  • Hematology & Oncology Physician
  • San Antonio, TX
National Provider Identifier
1417065947
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
CANCER CARE NETWORK OF SOUTH TEXAS PA
Practice address
8715 Village Dr
Suite#514
San Antonio, TX 78217-5405
Phone
(210) 637-0641
Fax
(210) 637-0613
NPI assigned
Aug 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Authorized official

Name
Dr. David H Gordon, M.D.
Title
President
Phone
(210) 545-6972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

8715 Village Dr
Suite#514
San Antonio, TX 78217-5405

Mailing address

8715 Village Dr
Suite#514
San Antonio, TX 78217-5405
Phone (210) 637-0641

Other identifiers 2

IdentifierTypeStateIssuer
109514302MedicaidTX
00U40QOtherTXBLUECROSS/BLUESHIELD TX

Other names 1

  • N.E.North-S.A.Tumor&Blood Clinic,PA Other name

National Provider Directory

National Provider Directory
Tax ID family
Michael McGrath11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1417065947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8715 VILLAGE DR",
            "address_2": "SUITE#514",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175405",
            "telephone_number": "210-637-0641",
            "fax_number": "210-637-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8715 VILLAGE DR",
            "address_2": "SUITE#514",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175405",
            "telephone_number": "210-637-0641",
            "fax_number": "210-637-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE NETWORK OF SOUTH TEXAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-545-6972",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109514302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD TX",
            "identifier": "00U40Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N.E.North-S.A.Tumor&Blood Clinic,PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.