Provider Demographics
NPI:1750359519
Name:CENTER FOR ONCOLOGY RESEARCH AND TREATMENT PA
Entity type:Organization
Organization Name:CENTER FOR ONCOLOGY RESEARCH AND TREATMENT PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MIRTSCHING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-566-5588
Mailing Address - Street 1:7777 FOREST LANE
Mailing Address - Street 2:SUITE B242
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230
Mailing Address - Country:US
Mailing Address - Phone:972-566-5588
Mailing Address - Fax:972-556-5587
Practice Address - Street 1:7777 FOREST LANE
Practice Address - Street 2:SUITE B242
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:972-566-5588
Practice Address - Fax:972-556-5587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4558207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185057001Medicaid
TX00245RMedicare PIN