Brazos Valley Cancer Clinics, PLLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

J0459 Issued in TX

Legal business name

BRAZOS VALLEY CANCER CLINICS, PLLC

Practice address

605 Medical CT
Suite 202
Brenham, TX 77833-5404

Phone

(979) 830-0700

Fax

(979) 251-9996

NPI assigned

Dec 29, 2006

Last updated

Nov 29, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raj Cheruku, MD

Title

Owner

Phone

(979) 830-0700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1972669406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MEDICAL COURT",
            "address_2": "SUITE 202",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "77833",
            "telephone_number": "979-830-0700",
            "fax_number": "979-251-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 MEDICAL CT",
            "address_2": "SUITE 202",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778335404",
            "telephone_number": "979-830-0700",
            "fax_number": "979-251-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS VALLEY CANCER CLINICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "CHERUKU",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-830-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "J0459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00X743",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon F Bode, MD
• Rachel Lynn Boer, PHARMD
• Matthew Howard Boutte, PA-C, MPAS
• Brandon Guillory OD
• Brazos Valley Apex Pain Specialists PLLC
• Brazos Valley Mental Health and Wellness, LLC
• Brenham Anesthesia Associates PA
• Brenham Care Center
• Brenham Clinic Assn
• Brenham Clinic Assn

• Hematology & Oncology Physician in Brenham, TX
• Providers in Brenham, TX by specialty
• Hematology & Oncology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.