Provider Demographics
NPI:1841453867
Name:ONCOL THERAPEUTICS PA
Entity type:Organization
Organization Name:ONCOL THERAPEUTICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOP
Authorized Official - Prefix:DR
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:713-524-1585
Mailing Address - Street 1:1200 BINZ ST STE 1490
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6946
Mailing Address - Country:US
Mailing Address - Phone:713-524-1585
Mailing Address - Fax:
Practice Address - Street 1:1200 BINZ ST STE 1490
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6946
Practice Address - Country:US
Practice Address - Phone:713-524-1585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8850261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX815004Medicare PIN
TX81501Medicare PIN