Basic Information
| Provider Information | |||||||||
| NPI: | 1760617609 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DALLAS ONCOLOGY CONSULTANTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 310 E HIGHWAY 67 | ||||||||
| Address2: | |||||||||
| City: | DUNCANVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751374159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722832389 | ||||||||
| FaxNumber: | 9722831424 | ||||||||
| Practice Location | |||||||||
| Address1: | 221 W COLORADO BLVD | ||||||||
| Address2: | STE.525 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752082363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2719483235 | ||||||||
| FaxNumber: | 2149483237 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2009 | ||||||||
| LastUpdateDate: | 07/20/2010 | ||||||||
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| AuthorizedOfficialLastName: | HOWELL | ||||||||
| AuthorizedOfficialFirstName: | JEAN | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9722832389 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | DALLAS ONCOLOGY CONSULTANTS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.