NPIMap

Organization Active NPI

Cancer Care Network of South Texas PA

  • Hematology & Oncology Physician
  • San Antonio, TX
National Provider Identifier
1790893204
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
4025 E Southcross Blvd
Building#5, Suite#30
San Antonio, TX 78222-3641
Phone
(210) 337-4494
Fax
(210) 337-4651
NPI assigned
Aug 25, 2006
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 Physician 207RH0003X NU Primary

Addresses

Primary practice location

4025 E Southcross Blvd
Building#5, Suite#30
San Antonio, TX 78222-3641

Mailing address

4025 E Southcross Blvd
Building#5, Suite#30
San Antonio, TX 78222-3641
Phone (210) 337-4494

Other identifiers 2

IdentifierTypeStateIssuer
109514302MedicaidTX
00U40QOtherTXBLUECROSS/BLUESHIELD TX

Other names 1

  • Southeast-S.A.Tumor & Blood Clinic Other name

National Provider Directory

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": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1790893204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 E SOUTHCROSS BLVD",
            "address_2": "BUILDING#5, SUITE#30",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782223641",
            "telephone_number": "210-337-4494",
            "fax_number": "210-337-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 E SOUTHCROSS BLVD",
            "address_2": "BUILDING#5, SUITE#30",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782223641",
            "telephone_number": "210-337-4494",
            "fax_number": "210-337-4651"
        }
    ],
    "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": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "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": "Southeast-S.A.Tumor & Blood Clinic",
            "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.