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General NPI Number Information
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NPI Number | 1376154534
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Entity Type | Organization
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Legal Business Name | GENESISCARE LANDMARK TEXAS CANCER CARE PA
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Dates
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Enumeration Date | 08/12/2020
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 12705 TOEPPERWEIN RD
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City | LIVE OAK
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State | TX
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Zip | 78233-3257
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Country | US
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Telephone | 210-816-4770
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Fax | 210-981-3051
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Provider Business Mailing Address
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Address Line | PO BOX 936823
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City | ATLANTA
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State | GA
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Zip | 31193-3213
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Country | US
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Telephone | 210-981-3051
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Fax | 210-981-3052
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | HEJAL C PATEL
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Credential | MD
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Telephone | 334-797-0829
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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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