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General NPI Number Information
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NPI Number | 1467479154
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Entity Type | Organization
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Legal Business Name | LONE STAR CANCER & BLOOD DISORDER, PA
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 925 SAN PEDRO AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78212-4643
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Country | US
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Telephone | 210-227-6156
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Fax | 210-527-1446
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Provider Business Mailing Address
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Address Line | PO BOX 781905
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City | SAN ANTONIO
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State | TX
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Zip | 78278-1905
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Country | US
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Telephone | 210-227-6156
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Fax | 210-527-1446
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. DEVEN BHACHAWAT
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Credential | MD
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Telephone | 210-227-6156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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