Provider Demographics
NPI:1164665147
Name:CANCER RADIATION & SPECIALTY CLINICS OF EL PASO. PA
Entity Type:Organization
Organization Name:CANCER RADIATION & SPECIALTY CLINICS OF EL PASO. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:H
Authorized Official - Last Name:FIERRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-533-2888
Mailing Address - Street 1:7812 GATEWAY EAST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915
Mailing Address - Country:US
Mailing Address - Phone:915-533-2888
Mailing Address - Fax:915-849-1220
Practice Address - Street 1:7812 GATEWAY BLVD E
Practice Address - Street 2:SUITE 110
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1815
Practice Address - Country:US
Practice Address - Phone:915-533-2888
Practice Address - Fax:915-849-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF43497Medicare UPIN