NPIMap

Organization Active NPI

Cancer Care Network of South Texas PA

  • Hematology & Oncology Physician
  • Marble Falls, TX
National Provider Identifier
1619023355
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
E9664 Issued in TX
Legal business name
CANCER CARE NETWORK OF SOUTH TEXAS PA
Practice address
715 FM 1431E
Marble Falls, TX 78654
Phone
(830) 693-0555
NPI assigned
Jan 26, 2007
Last updated
May 26, 2010By the provider in NPPES
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.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
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X E9664 TX Primary

Addresses

Primary practice location

715 FM 1431E
Marble Falls, TX 78654

Mailing address

715 FM 1431E
Marble Falls, TX 78654
Phone (830) 693-0555

Other identifiers 2

IdentifierTypeStateIssuer
109514302MedicaidTX
00U40QOtherTXBLUECROSS BLUESHIELD TX

Other names 1

  • Marble Falls Office-S.A.Tumor & Blood Clinic Other name

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": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1619023355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 FM 1431E",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "78654",
            "telephone_number": "830-693-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 FM 1431E",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "78654",
            "telephone_number": "830-693-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE NETWORK OF SOUTH TEXAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "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": "TX",
            "license": "E9664",
            "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": "Marble Falls Office-S.A.Tumor & Blood Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marble Falls, 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.