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General NPI Number Information
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NPI Number | 1023337169
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Entity Type | Organization
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Legal Business Name | CANCER CENTER ASSOCIATES
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 2698 N GALLOWAY AVE 103
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City | MESQUITE
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State | TX
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Zip | 75150
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Country | US
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Telephone | 972-686-6646
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Fax | 214-905-7550
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Provider Business Mailing Address
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Address Line | 2540 N GALLOWAY AVE 304
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City | MESQUITE
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State | TX
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Zip | 75150
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Country | US
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Telephone | 214-424-3613
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Fax | 214-905-7550
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMANULLAH KHAN
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Credential | M.D.
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Telephone | 214-424-3613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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