Provider Demographics
NPI:1851613095
Name:INNOVENT ONCOLOGY, LLC
Entity Type:Organization
Organization Name:INNOVENT ONCOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT. GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-863-1000
Mailing Address - Street 1:10101 WOODLOCH FOREST DR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1975
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10101 WOODLOCH FOREST DR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1975
Practice Address - Country:US
Practice Address - Phone:281-830-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US ONCOLOGY CORPORATE , INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management