Provider Demographics
NPI:1356415004
Name:RADIATION ONCOLOGY ASSOCIATES OF SOUTH TEXAS, L.L.P.
Entity type:Organization
Organization Name:RADIATION ONCOLOGY ASSOCIATES OF SOUTH TEXAS, L.L.P.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:LING
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHD
Authorized Official - Phone:361-576-9812
Mailing Address - Street 1:1502 E RED RIVER ST
Mailing Address - Street 2:#347
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5523
Mailing Address - Country:US
Mailing Address - Phone:361-576-9812
Mailing Address - Fax:361-574-1580
Practice Address - Street 1:2807 N BEN WILSON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5730
Practice Address - Country:US
Practice Address - Phone:361-576-9812
Practice Address - Fax:361-574-1580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00F16EOtherBLUE CROSS BLUE SHIELD
1538248695OtherKARL K. CHEN, M.D., NPI
TXCS4948OtherRAIL ROAD MEDICARE
TXE21013OtherKARL K. CHEN, M.D., UPIN
TX082420301Medicaid
1093894198OtherDAVID L. JANSSEN, M.D., NPI
TXA13659OtherDAVID L. JANSSEN,MD, UPIN
TXE21013OtherKARL K. CHEN, M.D., UPIN
TXF16EMedicare ID - Type Unspecified