1053446534 NPI number — WESTERM RADIATION ONCOLOGY ASSOCIATES, P.A.

Table of content: (NPI 1053446534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053446534 NPI number — WESTERM RADIATION ONCOLOGY ASSOCIATES, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTERM RADIATION ONCOLOGY ASSOCIATES, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053446534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 203594
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75320-3594
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-517-0262
Provider Business Mailing Address Fax Number:
281-517-0263

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21216 NORTHWEST FREEWAY
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
CYPRESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-912-3650
Provider Business Practice Location Address Fax Number:
832-912-3838
Provider Enumeration Date:
02/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BEHAR
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
ALEXANDER
Authorized Official Title or Position:
PRESIDENT CEO
Authorized Official Telephone Number:
281-517-0262

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 141634902 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00U09E . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: CJ4437 . This is a "MEDICARE RAILROAD UPIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com