CANCER CARE NETWORK OF SOUTH TEXAS PA (NPI# 1710095302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710095302 |
| Entity Type | Organization |
| Organization Name | CANCER CARE NETWORK OF SOUTH TEXAS PA |
| Other Organization Name | FREDERICKSBURG-S.A.TUMOR & BLOOD |
| Practice Address |
204 W Schubert St Fredericksburg TX 78624-3847 |
| Mailing Address |
100 Ne Loop 410 Suite 600 San Antonio TX 78216-4700 |
| Practice Telephone | 2102426541 |
| Practice Fax Number | 2102125136 |
| Mailing Telephone | 2102426541 |
| Mailing Fax Number | 2102125136 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2011-10-20 |
| Authorized Official Name | DR. DAVID H GORDON (PRESIDENT) |
| Authorized Official Telephone | 2105456972 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 109514302 | 05 | |
| TX | BLUECROSS/BLUESHIELD TX | 00U40Q | 01 |
| Other Name | Type Code |
|---|---|
| Fredericksburg-S.A.Tumor & Blood | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316198443 | Cancer Care Network of South Texas Pa | Internal Medicine | 1340 E Walnut St, Ste. 1348, Seguin, TX 78155-5126 | 2008-10-07 |
| 1851542971 | Cancer Care Network of South Texas Pa | Internal Medicine | 1448 E. Common St., New Braunfels, TX 78130-3162 | 2008-10-07 |
| 1841441961 | Cancer Care Network of South Texas Pa | Internal Medicine | 4411 Medical Drive, Ste. 100, San Antonio, TX 78229-3832 | 2008-10-07 |
| 1881845162 | Cancer Care Network of South Texas Pa | Internal Medicine | 606 31st St, Hondo, TX 78861-3512 | 2008-10-06 |
| 1942486964 | Cancer Care Network of South Texas Pa | Internal Medicine | 2130 N.e. Loop 410, Suite #100, San Antonio, TX 78217-4660 | 2008-01-22 |
| 1801913462 | Cancer Care Network of South Texas Pa | Internal Medicine | 1100 Mission Hills, #200, Marble Falls, TX 78654 | 2007-03-26 |
| 1619023355 | Cancer Care Network of South Texas Pa | Internal Medicine | 715 Fm 1431e, Marble Falls, TX 78654 | 2007-01-26 |
| 1225064603 | Cancer Care Network of South Texas Pa | Internal Medicine | 100 Ne Loop 410, Suite # 600, San Antonio, TX 78216-4700 | 2006-06-25 |
| 1841513256 | Cancer Care Network of South Texas Pa | Internal Medicine | 5000 Baptist Health Dr, Ste. 116, Schertz, TX 78154-1193 | 2010-03-12 |
| 1336390269 | Cancer Care Network of South Texas Pa | Internal Medicine | 4411 Medical Drive, Ste. 100, San Antonio, TX 78229-3832 | 2008-10-09 |
| Street Address |
204 W SCHUBERT ST |
| City | FREDERICKSBURG |
| State | TX |
| Zip Code | 78624-3847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174553465 | Dianne Denise Pittman | Nurse Practitioner | 204 W Schubert St, Fredericksburg, TX 78624-3847 | 2006-07-03 |
| 1952317232 | Jose A Lopez | Internal Medicine | 204 W Schubert St, Fredericksburg, TX 78624-3847 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992357669 | Cynthia Hui Kim | Registered Nurse | 1020 S State, Tx-16, Fredericksburg, TX 78624 | 2019-07-12 |
| 1023515533 | Fredericksburg Eye Associates, Pllc | Ophthalmology | 755 S. Washington St., Fredericksburg, TX 78624 | 2018-04-11 |
| 1922503358 | Ave Maria Hospice of Fredericksburg, LLC | Hospice Care, Community Based | 204 S. Adams St. #a, Fredericksburg, TX 78624 | 2018-03-27 |
| 1225568546 | David Ronald Rickerhauser | Counselor | 400 Prairie View Trail, Fredericksurg, TX 78624 | 2017-06-19 |
| 1144629734 | Amy Taylor | Nurse Practitioner | 1020 Hwy 16, Fredericksburg, TX 78624 | 2014-08-19 |
| 1578836532 | James W. Harrington Jr. | Otolaryngology | 644 Red Oak Lane, Fredericksburg, TX 78624 | 2012-02-21 |
| 1366676447 | Pamela Elaine Hansen | Counselor | 607 Pesimmon Ct., Fredericksburg, TX 78624 | 2009-05-05 |
| 1457526048 | Celine Bicquart Ord | Radiology | 753 S Washington St Bldg D, Fredericksburg, TX 78624 | 2008-04-24 |
| 1669669024 | Rebecca S Prescott | Dentist | 408 N Milam St, Fredericksburg, TX 78624 | 2007-10-01 |
| 1407046626 | Charles Richard Massey Jr. | General Practice | 103 Goehmann Lane, Fredericksburg, TX 78624 | 2007-07-25 |
| Find all providers in zip 78624 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437253788 | Leroy J Essig | Internal Medicine | 240 Executive Center Parkway, Fredericksburg, VA 22401-3107 | 2006-09-08 |
| 1588681233 | Fredericksburg Oncology, Inc. | Internal Medicine | 111 Park Hill Dr, Suite B, Fredericksburg, VA 22401-3357 | 2006-07-17 |
| 1356371157 | Sudeep Joseph Menachery | Internal Medicine | 4501 Empire Court, Fredericksburg, VA 22408 | 2006-07-04 |
| 1275025546 | Keri Amanda Bradshaw | Internal Medicine | 406 Chatham Square Office Park, Fredericksburg, VA 22405-2585 | 2018-06-03 |
| 1538667498 | Leslie Cooper | Internal Medicine | 4501 Empire Ct, Fredericksburg, VA 22408-1949 | 2018-01-25 |
| 1881121614 | Virginia Oncology Care,pc | Internal Medicine | 406 Chatham Square Office Park, Fredericksburg, VA 22405-2585 | 2017-05-11 |
| 1205386729 | Jamie Mcdowell | Internal Medicine | 406 Chatham Square Office Park, Fredericksburg, VA 22405-2585 | 2016-10-07 |
| 1194164418 | Archana Jadhav | Internal Medicine | 406 Chatham Square Office Park, Fredericksburg, VA 22405-2585 | 2013-06-19 |
| 1902048051 | Bonny Lauren Moore | Internal Medicine | 4501 Empire Ct, Fredericksburg, VA 22408-1949 | 2009-04-02 |
| 1114015989 | Nicholas A. Cook | Internal Medicine | 406 Chatham Square Office Park, Fredericksburg, VA 22405-2585 | 2006-10-10 |
| Find all providers in FREDERICKSBURG | ||||
| City | FREDERICKSBURG |
| Zip Code | 78624 |
Please comment or provide details below to improve the information on CANCER CARE NETWORK OF SOUTH TEXAS PA.
| 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.