Provider Demographics
NPI:1487679353
Name:TEXAS HEMATOLOGY / ONCOLOGY CENTER, P.A.
Entity Type:Organization
Organization Name:TEXAS HEMATOLOGY / ONCOLOGY CENTER, P.A.
Other - Org Name:TEXAS HEMATOLOGY / ONCOLOGY CENTER, P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SABIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-247-5510
Mailing Address - Street 1:10 MEDICAL PKWY
Mailing Address - Street 2:PLAZA 3, SUITE#106
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7840
Mailing Address - Country:US
Mailing Address - Phone:972-247-5510
Mailing Address - Fax:972-243-9178
Practice Address - Street 1:10 MEDICAL PKWY
Practice Address - Street 2:PLAZA 3, SUITE#106
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7840
Practice Address - Country:US
Practice Address - Phone:972-247-5510
Practice Address - Fax:972-488-7382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081244802Medicaid
TX081244802Medicaid
0083BYMedicare PIN
DA0094Medicare PIN
TX1200800001Medicare NSC