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General NPI Number Information
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NPI Number | 1194079376
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Entity Type | Organization
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Legal Business Name | CENTURY RADIATION ONCOLOGY LUBBOCK, PLLC
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 424 N. UTICA
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City | LUBBOCK
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State | TX
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Zip | 79416-3035
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Country | US
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Telephone | 806-776-8200
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Fax | 806-771-4177
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Provider Business Mailing Address
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Address Line | 424 N. UTICA
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City | LUBBOCK
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State | TX
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Zip | 79416-3035
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Country | US
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Telephone | 806-776-8200
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Fax | 806-771-4177
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Authorized Official
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Title or Position | MEDICAL
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Name | DR. SANJAY C MEHTA
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Credential | M.D.
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Telephone | 713-589-6879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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