Provider Demographics
NPI:1881728616
Name:CLINICAL ONCOLOGY & HEMATOLOGY, LLP
Entity type:Organization
Organization Name:CLINICAL ONCOLOGY & HEMATOLOGY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFCIER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUGELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-566-7766
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:STE C-850
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2571
Mailing Address - Country:US
Mailing Address - Phone:972-566-7766
Mailing Address - Fax:972-566-7796
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:STE C-850
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:972-566-7766
Practice Address - Fax:972-566-7796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180168001Medicaid
TX0099NCOtherBLUE CROSS BLUE SHIELD
TXDE0509OtherRAILROAD MEDICARE
TX180168001Medicaid