Provider Demographics
NPI: | 1376075499 |
---|---|
Name: | HORIZON HEMATOLOGY ONCOLOGY HEALTH ORGANIZATION |
Entity Type: | Organization |
Organization Name: | HORIZON HEMATOLOGY ONCOLOGY HEALTH ORGANIZATION |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | MUKESH KUMAR |
Authorized Official - Middle Name: | DEVSHIBHAI |
Authorized Official - Last Name: | DELVADIYA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 214-668-4809 |
Mailing Address - Street 1: | 6404 INTERNATIONAL PKWY |
Mailing Address - Street 2: | SUITE 1010 |
Mailing Address - City: | PLANO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75093-8225 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 972-267-1988 |
Mailing Address - Fax: | 972-267-3434 |
Practice Address - Street 1: | 6404 INTERNATIONAL PKWY |
Practice Address - Street 2: | SUITE 1010 |
Practice Address - City: | PLANO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75093-8225 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-267-1988 |
Practice Address - Fax: | 972-267-3434 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-03-29 |
Last Update Date: | 2017-03-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
1041C0700X, 163WX0200X, 1835X0200X, 207RH0000X, 207RH0002X, 207RX0202X, 2085R0001X, 347C00000X, 363AM0700X, 364SM0705X, 364SX0200X, 405300000X | ||
TX | P2430 | 207R00000X, 207RH0003X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 163WX0200X | Nursing Service Providers | Registered Nurse | Oncology | Group - Multi-Specialty |
No | 1835X0200X | Pharmacy Service Providers | Pharmacist | Oncology | Group - Multi-Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RH0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | Group - Multi-Specialty |
No | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | Group - Multi-Specialty |
No | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | Group - Multi-Specialty |
No | 347C00000X | Transportation Services | Private Vehicle | Group - Multi-Specialty | |
No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
No | 364SM0705X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Medical-Surgical | Group - Multi-Specialty |
No | 364SX0200X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Oncology | Group - Multi-Specialty |
No | 405300000X | Other Service Providers | Prevention Professional | Group - Multi-Specialty |