Basic Information
| Provider Information | |||||||||
| NPI: | 1679578926 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABILENE HEMAT ONCO GRP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 PINE ST | ||||||||
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| City: | ABILENE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 796012434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3256730100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2000 PINE ST | ||||||||
| Address2: | |||||||||
| City: | ABILENE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 796012434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3256730100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | HIRSCH | ||||||||
| AuthorizedOfficialFirstName: | VICTOR | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3256730100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MS,MD, FACP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 082227206 | 05 | TX | MEDICAID |