Organization Active NPI

South Texas Radiation Oncology PLLC

  • Radiation Oncology Physician
  • Lake Jackson, TX
National Provider Identifier
1962044628
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
SOUTH TEXAS RADIATION ONCOLOGY PLLC
Practice address
100B Medical Dr
Lake Jackson, TX 77566-5674
Phone
(979) 297-9268
NPI assigned
Oct 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Authorized official

Name
Dr. Daniel Ray Garlitos, MDNPI 1386629574
Title
Owner
Phone
(832) 549-3961

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

100B Medical Dr
Lake Jackson, TX 77566-5674

Mailing address

100B Medical Dr
Lake Jackson, TX 77566-5674
Phone (979) 297-9268

Other identifiers 1

IdentifierTypeStateIssuer
029882006MedicaidTX

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.

NPI Registry JSON

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1962044628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100B MEDICAL DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665674",
            "telephone_number": "979-297-9268",
            "fax_number": "979-297-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100B MEDICAL DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665674",
            "telephone_number": "979-297-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS RADIATION ONCOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "GARLITOS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-549-3961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029882006",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.