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General NPI Number Information
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NPI Number | 1255569679
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Entity Type | Organization
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Legal Business Name | CENTURY RADIATION ONCOLOGY PLLC
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 9150 S MAIN ST SUITE A-3
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City | HOUSTON
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State | TX
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Zip | 77025-3843
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Country | US
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Telephone | 713-630-8161
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Fax |
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Provider Business Mailing Address
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Address Line | 6565 WEST LOOP S SUITE 400
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City | BELLAIRE
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State | TX
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Zip | 77401-3500
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Country | US
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Telephone | 713-589-6879
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANJAY C MEHTA
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Credential | MD
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Telephone | 713-630-8161
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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 | K9353
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License Number State | TX
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