NPIMap

Organization Active NPI

Cancer Care Network of South Texas PA

  • Therapeutic Radiology Physician
  • San Antonio, TX
National Provider Identifier
1437251535
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Therapeutic Radiology PhysicianTaxonomy code 2085R0203X
Legal business name
CANCER CARE NETWORK OF SOUTH TEXAS PA
Practice address
1200 Brooklyn Ave
Suite#115
San Antonio, TX 78212-4803
Phone
(210) 224-6531
Fax
(210) 226-0402
NPI assigned
Sep 1, 2006
Last updated
May 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 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.NPI 1427079243
Title
President
Phone
(210) 545-6972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Therapeutic Radiology Physician 2085R0203X Primary

Addresses

Primary practice location

1200 Brooklyn Ave
Suite#115
San Antonio, TX 78212-4803

Mailing address

1200 Brooklyn Ave
Suite#115
San Antonio, TX 78212-4803
Phone (210) 224-6531

Other identifiers 2

IdentifierTypeStateIssuer
00U40QOtherTXBLUECROSS/BLUESHIELD TX
109514302MedicaidTX

Other names 1

  • Radiation-San Antonio Tumor&Blood 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.

Locations

1200 Brooklyn Ave
Ste 115
San Antonio, TX 78212
Phone (210) 224-6531

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274918400000",
    "number": "1437251535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE",
            "address_2": "SUITE#115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124803",
            "telephone_number": "210-224-6531",
            "fax_number": "210-226-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE",
            "address_2": "SUITE#115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124803",
            "telephone_number": "210-224-6531",
            "fax_number": "210-226-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE NETWORK OF SOUTH TEXAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2010-05-27",
        "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": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD TX",
            "identifier": "00U40Q",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109514302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiation-San Antonio Tumor&Blood",
            "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 27, 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.