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NPI Code Detail

MEDICARE: MONCRIEF CANCER CENTER

MEDICARE: MONCRIEF CANCER CENTER
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
1261QX0203XRadiation Oncology Clinic/CenterL00384TX
2261QX0203XRadiation Oncology Clinic/CenterR01948TX

General Provider Information

NPI Number : 1831192863
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONCRIEF CANCER CENTER
Provider Business Mailing Address
First Line : 1450 8TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4110
Country : US
Telephone Number : 817-923-7393
Fax Number : 817-927-4532
Provider Business Practice Location Address
First Line : 1450 8TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4110
Country : US
Telephone Number : 817-923-7393
Fax Number : 817-927-4532
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. WILLIAM CRAIG
Credential :
Telephone Number : 817-927-6323
Provider Enumeration Date : 05/23/2005
Last Update Date : 08/22/2020

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Directions to “MONCRIEF CANCER CENTER ” Practice Location

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