GULF COAST CANCER & DIAGNOSTIC CENTER AT SOUTHEAST (NPI# 1194723296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194723296 |
| Entity Type | Organization |
| Organization Name | GULF COAST CANCER & DIAGNOSTIC CENTER AT SOUTHEAST |
| Other Organization Name | UNIVERSITY DIAGNOSTIC AND TREATMENT CLINIC |
| Practice Address |
12811 Beamer Rd Houston TX 77089-6140 |
| Mailing Address |
Po Box 7894 Pasadena TX 77508-7894 |
| Practice Telephone | 7134741414 |
| Practice Fax Number | 7134748477 |
| Mailing Telephone | 7134741414 |
| Mailing Fax Number | 7134748477 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2016-04-19 |
| Authorized Official Name | MARK A DANDREA (OWNER) |
| Authorized Official Telephone | 7134741414 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 261QX0203X |
Clinic/Center Specialization: Oncology, Radiation |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS | 0212DC | 01 |
| TX | 149577201 | 05 |
| Other Name | Type Code |
|---|---|
| University Diagnostic and Treatment Clinic | Doing Business As Name - Organization |
| Street Address |
12811 BEAMER RD |
| City | HOUSTON |
| State | TX |
| Zip Code | 77089-6140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023364155 | University Diagnostic & Treatment Clinic Pllc | Internal Medicine | 12811 Beamer Rd, Houston, TX 77089-6140 | 2012-07-26 |
| 1255646378 | South East Surgi-center Inc | Clinic/Center | 12811 Beamer Rd, Houston, TX 77089-6140 | 2010-08-12 |
| 1528259520 | Spine and Joint Pain Center, Pa | Physical Medicine & Rehabilitation | 12811 Beamer Rd, Houston, TX 77089-6140 | 2007-08-05 |
| 1417032905 | Gregory L Smith | Plastic Surgery | 12811 Beamer Rd, Houston, TX 77089-6140 | 2006-10-25 |
| 1326081993 | Mark A D'andrea | Radiology | 12811 Beamer Rd, Houston, TX 77089-6140 | 2006-06-13 |
| 1972541076 | Gulf Coast Oncology Associates Pa | Radiology | 12811 Beamer Rd, Houston, TX 77089-6140 | 2006-06-02 |
| 1700875069 | Katy West Houston Anesthesia Pa | Anesthesiology | 12811 Beamer Rd, Ste C, Houston, TX 77089-6140 | 2005-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578117040 | Sehat Medical Transporters | Non-emergency Medical Transport (VAN) | 11881 Gulf Pointe Dr, Apt D12, Houston, TX 77089 | 2019-08-01 |
| 1780165225 | Cindie Wilson-le | Physical Therapist | 11902 Resoure Pkwy, Houston, TX 77089 | 2018-08-23 |
| 1760963219 | Stephanie Balli | Occupational Therapy Assistant | 10800 Flora Mae Meadows, Houston, TX 77089 | 2018-08-23 |
| 1669965166 | Every Day Matters LLC | Technician | 10418 Sageglow Dr, Houston, TX 77089 | 2018-06-08 |
| 1457867723 | Lakiesha A Talbert | Counselor | 11519 Cecil Summers Way, Houston, TX 77089 | 2017-12-21 |
| 1245754936 | Think Moore | Voluntary or Charitable | 10630 Seaford Dr, Houston, TX 77089 | 2017-08-03 |
| 1386164887 | Bryan Nguyen | Dentist | 11911 Meadow Hawk Dr., Houston, TX 77089 | 2017-06-26 |
| 1750742771 | Sharon Allen | Speech-Language Pathologist | 11144 Fuqua St. #518, Houston, TX 77089 | 2016-03-18 |
| 1699130914 | Fresenius Medical Care Beamer, LLC | Clinic/Center | 12727 Beamer Road, Houston, TX 77089 | 2015-12-31 |
| 1255743811 | Natalie Marie Fitzgerald | Nurse Practitioner | 11914 Astoria Blvd., Suite 510, Houston, TX 77089 | 2014-05-29 |
| Find all providers in zip 77089 | ||||
| Taxonomy Code | 261QX0203X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology, Radiation |
| Definition to come... |
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|---|---|---|---|---|
| 1174610786 | Thanh John Van Md Pa | Clinic/Center | 1415 Hyde Park Blvd Unit C, Houston, TX 77006-2503 | 2006-10-06 |
| 1760462709 | Proton Therapy Center-houston Ltd | Clinic/Center | 1840 Old Spanish Trail, Houston, TX 77054-2002 | 2006-01-17 |
| 1447258520 | Houston Northwest Radiotherapy Center | Clinic/Center | 810 Peakwood Dr, Suite D, Houston, TX 77090-2921 | 2005-07-12 |
| 1578711578 | The Amerivest Group, Inc. | Clinic/Center | 908 Town and Country Blvd, Suite 120, Houston, TX 77024-2221 | 2008-09-03 |
| 1689683211 | North Houston Medicine Tumor & Blood Clinic, P.a. | Clinic/Center | 1631 North Loop W, Ste 100, Houston, TX 77008-1539 | 2006-08-05 |
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| 1639538655 | Golden Triangle Cancer Center LLC | Clinic/Center | 2875 Jimmy Johnson Blvd, Suite 100, Port Arthur, TX 77640-2002 | 2016-02-18 |
| 1811315286 | Dominic Himchan Moon | Clinic/Center | 2280 Inwood Road, Dallas, TX 75390-7512 | 2014-04-02 |
| 1023443223 | Americare Cancer Centers, Gp; LLC | Clinic/Center | 2507 Stonebury Ln, Sugar Land, TX 77479-5489 | 2013-09-06 |
| 1760739098 | North Texas Srs LLC | Clinic/Center | 10425 N Central Expy, Dallas, TX 75231-2208 | 2012-08-06 |
| 1922388503 | Altus Radiation Oncology Beaumont, Lp | Clinic/Center | 310 N 11th St, Beaumont, TX 77702-1802 | 2011-08-26 |
| 1508178229 | Usmd Cancer Treatment Centers, LLC | Clinic/Center | 801 West Interstate 20, Suite 1, Arlington, TX 76017-3252 | 2010-07-10 |
| 1285955708 | Altus Radiation Oncology (baytown) Lp | Clinic/Center | 1455 Manor Drive, Suite 150, Baytown, TX 77521 | 2010-06-18 |
| 1861711392 | Noushin Izadifar Hart, M.d. P.a. | Clinic/Center | 10 W Whistlers Bend Cir, Conroe, TX 77384-5061 | 2010-05-24 |
| 1689853038 | University Cancer Center of Huntsville Brenham Inc | Clinic/Center | 521 Interstate 45 S, Suite 10, Huntsville, TX 77340-5650 | 2007-11-01 |
| 1801910492 | Christus Santa Rosa Cancer Center | Clinic/Center | 310 N San Saba, San Antonio, TX 78207-3199 | 2007-03-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.