NPIMap

Organization Active NPI

Cancer Care Network of South Texas PA

  • Hematology & Oncology Physician
  • San Antonio, TX
National Provider Identifier
1942486964
Registry record updated Oct 27, 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
2130 N.E. Loop 410
Suite #100
San Antonio, TX 78217-4660
Phone
(210) 656-7177
Fax
(210) 656-3687
NPI assigned
Jan 22, 2008
Last updated
Oct 27, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
CANCER CARE NETWORK OF SOUTH TEXAS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 27, 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.
Title
President
Phone
(210) 656-7177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

2130 N.E. Loop 410
Suite #100
San Antonio, TX 78217-4660

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
109514302MedicaidTX
00U40QOtherTXBLUECROSS/BLUESHIELD TX

Other names 1

  • Northeast Cancer Center/SA Tumor & Blood Other name

National Provider Directory

National Provider Directory
Part of
Helen Laura Goldberg

Locations

1901 E State Highway 97
Ste 200
Jourdanton, TX 78026
Phone (830) 769-3135

694 Hill Country Dr
Kerrville, TX 78028
Phone (830) 792-3434

10515 State Highway 151
Ste 190
San Antonio, TX 78251
Phone (210) 618-8960

215 E Quincy St
Ste 310
San Antonio, TX 78215
Phone (210) 224-1345

3327 Research Plz
Ste 102
San Antonio, TX 78235
Phone (210) 337-4494

4025 E Southcross Blvd
Ste 30
San Antonio, TX 78222
Phone (210) 337-4494

4319 Medical Dr
Ste 205
San Antonio, TX 78229
Phone (210) 593-5250

502 Madison Oak Dr
#346
San Antonio, TX 78258
Phone (210) 277-6255

540 Madison Oak Dr
Ste 200
San Antonio, TX 78258
Phone (210) 545-6972

7335 Barlite
Ste 405
San Antonio, TX 78224

7711 Louis Pasteur Dr
Ste 504
San Antonio, TX 78229
Phone (210) 614-5110

8527 Village Dr
Ste 101
San Antonio, TX 78217
Phone (210) 617-3023

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1942486964",
    "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": "2130 N.E. LOOP 410",
            "address_2": "SUITE #100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782174660",
            "telephone_number": "210-656-7177",
            "fax_number": "210-656-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE NETWORK OF SOUTH TEXAS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CANCER CARE NETWORK OF SOUTH TEXAS, P.A.",
        "enumeration_date": "2008-01-22",
        "last_updated": "2011-10-27",
        "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": "210-656-7177",
        "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": "Northeast Cancer Center/SA 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 Oct 27, 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.