Healthcare Provider Details

I. General information

NPI: 1306125653
Provider Name (Legal Business Name): CANCER TREATMENT AND PREVENTION SPECIALIST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 10/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 S TELSHOR BLVD SUITE E
LAS CRUCES NM
88011-5069
US

IV. Provider business mailing address

7901 HEMBRILLO CANYON CT
LAS CRUCES NM
88011-8406
US

V. Phone/Fax

Practice location:
  • Phone: 575-556-5800
  • Fax: 575-556-5899
Mailing address:
  • Phone: 505-795-4152
  • Fax: 575-556-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. CHERIE J HAYOSTEK
Title or Position: DIRECTOR AND PRESIDENT
Credential: M.D.
Phone: 575-556-5800