Provider Demographics
NPI:1760617609
Name:DALLAS ONCOLOGY CONSULTANTS
Entity Type:Organization
Organization Name:DALLAS ONCOLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-283-2389
Mailing Address - Street 1:310 E HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-4159
Mailing Address - Country:US
Mailing Address - Phone:972-283-2389
Mailing Address - Fax:972-283-1424
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:STE.525
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:271-948-3235
Practice Address - Fax:214-948-3237
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DALLAS ONCOLOGY CONSULTANTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-21
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1138320001Medicare NSC