Healthcare Provider Details

I. General information

NPI: 1326001462
Provider Name (Legal Business Name): SCOTT & WHITE CENTER FOR CANCER PREVENTION AND CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 S CLEAR CREEK RD SUITE 101
KILLEEN TX
76549-4132
US

IV. Provider business mailing address

PO BOX 847408
DALLAS TX
75284-7408
US

V. Phone/Fax

Practice location:
  • Phone: 254-200-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: ALICE CANTU
Title or Position: ASSOC VICE PRESIDENT, RCO
Credential:
Phone: 254-215-9719