Basic Information
| Provider Information | |||||||||
| NPI: | 1548262900 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | WILLIAM | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 906 W RANDOL MILL RD | ||||||||
| Address2: | ARLINGTON CANCER CENTER | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760122510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172614906 | ||||||||
| FaxNumber: | 8175434675 | ||||||||
| Practice Location | |||||||||
| Address1: | 906 W RANDOL MILL RD | ||||||||
| Address2: | ARLINGTON CANCER CENTER | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760122510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172610929 | ||||||||
| FaxNumber: | 8175434658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 06/24/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | F2145 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | OS3674 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | DOS-561 | HI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 102212105 | 05 | TX | MEDICAID | 102212102 | 05 | TX | MEDICAID | 102212104 | 05 | TX | MEDICAID | 102212106 | 05 | TX | MEDICAID |