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General NPI Number Information
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NPI Number | 1053562181
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Entity Type | Organization
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Legal Business Name | CANCER CARE NETWORK OF SOUTH TEXAS PA
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 124 E. BANDERA RD. STE. 301
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City | BOERNE
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State | TX
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Zip | 78006-2852
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Country | US
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Telephone | 830-249-1429
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Fax | 830-249-1469
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Provider Business Mailing Address
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Address Line | 124 E. BANDERA RD. STE. 301
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City | BOERNE
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State | TX
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Zip | 78006-2852
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Country | US
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Telephone | 830-249-1429
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Fax | 830-249-1469
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROGER M LYONS
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Credential | MD
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Telephone | 210-595-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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