Provider Demographics
NPI:1164798997
Name:THOC PA
Entity Type:Organization
Organization Name:THOC PA
Other - Org Name:TEXAS HEMATOLOGY/ONCOLOGY CENTERS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:BIRENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-453-5500
Mailing Address - Street 1:12700 HILLCREST RD STE 110
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2055
Mailing Address - Country:US
Mailing Address - Phone:469-453-5500
Mailing Address - Fax:972-243-1285
Practice Address - Street 1:12700 HILLCREST RD STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2055
Practice Address - Country:US
Practice Address - Phone:469-453-5500
Practice Address - Fax:972-243-1285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX415652301Medicaid