Healthcare Provider Details

I. General information

NPI: 1871639179
Provider Name (Legal Business Name): ROWLETT REGIONAL CANCER CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 LAKEVIEW PKWY STE 200
ROWLETT TX
75088-4557
US

IV. Provider business mailing address

6300 BRIDGE POINT PKWY BLDG 2 STE 115
AUSTIN TX
78730-5073
US

V. Phone/Fax

Practice location:
  • Phone: 972-475-0960
  • Fax: 972-412-5219
Mailing address:
  • Phone: 512-583-2000
  • Fax: 512-583-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT STEVEN BRADFIELD
Title or Position: OWNER
Credential: MD
Phone: 574-315-8131