Provider Demographics
NPI:1942837158
Name:SOUTH TEXAS RADIATION ONCOLOGY PLLC
Entity Type:Organization
Organization Name:SOUTH TEXAS RADIATION ONCOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIATION ONCOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:GARLITOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-297-9268
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-0368
Mailing Address - Country:US
Mailing Address - Phone:979-297-9268
Mailing Address - Fax:979-297-9331
Practice Address - Street 1:100B MEDICAL DR
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5674
Practice Address - Country:US
Practice Address - Phone:979-297-9268
Practice Address - Fax:979-297-9331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty