NPIMap

Organization Active NPI

Cccst - Seguin

  • Hematology & Oncology Physician
  • Seguin, TX
National Provider Identifier
1497882245
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
E3811 Issued in TX
Legal business name
CCCST - SEGUIN
Practice address
1025 N Austin St
Seguin, TX 78155-4517
Phone
(830) 379-8688
Fax
(210) 595-5301
NPI assigned
Feb 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Roger M. Lyons, MDNPI 1508838285
Title
President
Phone
(210) 595-5300

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
Hematology & Oncology Physician 207RH0003X E3811 TX Primary

Addresses

Primary practice location

1025 N Austin St
Seguin, TX 78155-4517

Mailing address

4411 Medical Dr Ste 100
San Antonio, TX 78229-3832
Phone (210) 595-5300

National Provider Directory

National Provider Directory
Tax ID family
Helen Laura Goldberg11 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.

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": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497882245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 MEDICAL DR STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293832",
            "telephone_number": "210-595-5300",
            "fax_number": "210-614-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N AUSTIN ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781554517",
            "telephone_number": "830-379-8688",
            "fax_number": "210-595-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCCST - SEGUIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-595-5300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "E3811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.