NPIMap

Organization Active NPI

Cancer Care Network of South Texas PA

  • Radiation Oncology Physician
  • San Antonio, TX
National Provider Identifier
1972762284
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
CANCER CARE NETWORK OF SOUTH TEXAS PA
Practice address
2130 NE Loop 410
Suite 100
San Antonio, TX 78217-4659
Phone
(210) 656-7177
Fax
(210) 656-3687
NPI assigned
Jun 3, 2008
Organization subpart
No

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, MD
Title
President
Phone
(210) 656-7177

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X Primary
Therapeutic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0203X

Addresses

Primary practice location

2130 NE Loop 410
Suite 100
San Antonio, TX 78217-4659

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

  • NECancer Center Radiology SATBC Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1972762284",
    "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 NE LOOP 410",
            "address_2": "SUITE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782174659",
            "telephone_number": "210-656-7177",
            "fax_number": "210-656-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE NETWORK OF SOUTH TEXAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "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": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Therapeutic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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": "NECancer Center Radiology SATBC",
            "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.