MEDICARE: TEXAS CANCER ASSOCIATES LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician

General Provider Information

NPI Number	:	1417946328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS CANCER ASSOCIATES LLP

Provider Business Mailing Address
First Line	:	PO BOX 650758
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0758
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8440 WALNUT HILL LN
Second Line	:	STE 600
City	:	DALLAS
State	:	TX
Zip	:	75231-3833
Country	:	US
Telephone Number	:	214-739-1706
Fax Number	:	214-368-0056

Authorized Official
Title or Position	:	CEO
Name	:	JIUESH SHARKA
Credential	:	MD
Telephone Number	:	972-739-1706

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	08/22/2020

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