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General NPI Number Information
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NPI Number | 1336120054
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Entity Type | Organization
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Legal Business Name | CANCER CARE CENTERS OF SOUTH TEXAS
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4411 MEDICAL DR, STE. 100
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3832
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Country | US
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Telephone | 210-595-5300
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Fax | 210-614-8740
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Provider Business Mailing Address
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Address Line | 4411 MEDICAL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3832
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Country | US
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Telephone | 210-595-5300
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Fax | 210-614-8740
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. 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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | E3811
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | E3811
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License Number State | TX
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