Provider Demographics
NPI:1720036650
Name:CONSULTANTS IN RADIATION ONCOLOGY, PA
Entity Type:Organization
Organization Name:CONSULTANTS IN RADIATION ONCOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-355-7267
Mailing Address - Street 1:1600 S. COULTER
Mailing Address - Street 2:SUITE, #402
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1721
Mailing Address - Country:US
Mailing Address - Phone:806-355-7267
Mailing Address - Fax:806-355-1823
Practice Address - Street 1:1500 WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1794
Practice Address - Country:US
Practice Address - Phone:806-354-5880
Practice Address - Fax:806-354-5890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00HJ26OtherBCBS
OK100750960AMedicaid
NM0000G4872Medicaid
TX094870501Medicaid
KS100293200AMedicaid
KS100293200AMedicaid
TX00HJ26OtherBCBS