NPIMap

Organization Active NPI

Cancer Care Network of South Texas PA

  • Hematology & Oncology Physician
  • Fredericksburg, TX
National Provider Identifier
1710095302
Registry record updated Oct 20, 2011
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
204 W Schubert St
Fredericksburg, TX 78624-3847
Phone
(210) 242-6541
Fax
(210) 212-5136
NPI assigned
Aug 25, 2006
Last updated
Oct 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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 Primary

Addresses

Primary practice location

204 W Schubert St
Fredericksburg, TX 78624-3847

Mailing address

100 NE Loop 410
Suite 600
San Antonio, TX 78216-4700
Phone (210) 242-6541

Other names 1

  • Fredericksburg-S.A.Tumor & Blood Other name

National Provider Directory

National Provider Directory

Locations

204 W Schubert St
Fredericksburg, TX 78624
Phone (210) 242-6541

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": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1710095302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NE LOOP 410",
            "address_2": "SUITE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782164700",
            "telephone_number": "210-242-6541",
            "fax_number": "210-212-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W SCHUBERT ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786243847",
            "telephone_number": "210-242-6541",
            "fax_number": "210-212-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE NETWORK OF SOUTH TEXAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-10-20",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fredericksburg-S.A.Tumor & Blood",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fredericksburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.