Provider Demographics
NPI:1982755732
Name:HEMATOLOGY ONCOLOGY SPECIALISTS OF TEXAS PA
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY SPECIALISTS OF TEXAS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:TULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-794-8861
Mailing Address - Street 1:PO BOX 3150
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78044-3150
Mailing Address - Country:US
Mailing Address - Phone:956-794-8861
Mailing Address - Fax:956-726-1220
Practice Address - Street 1:2412 JACAMAN RD.
Practice Address - Street 2:SUITE #103
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2700
Practice Address - Country:US
Practice Address - Phone:956-794-8861
Practice Address - Fax:956-726-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1788207RH0003X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDG2196OtherMEDICARE RAILROAD CARRIER
TX151459802Medicaid
TX00119PUOtherBLUE CROSS BLUE SHIELD
TXC22821Medicare UPIN
TX00119PUOtherBLUE CROSS BLUE SHIELD
TX0932080001Medicare NSC