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General NPI Number Information
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NPI Number | 1528150018
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Entity Type | Organization
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Legal Business Name | RADIATION MEDICINE ASSOCIATES
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 620 S BROADWAY ST
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City | MCALLEN
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State | TX
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Zip | 78501-4906
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Country | US
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Telephone | 956-212-4388
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Fax | 956-682-9915
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Provider Business Mailing Address
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Address Line | 3827 N 10TH STREET STE 304
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City | MCALLEN
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State | TX
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Zip | 78501-1749
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Country | US
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Telephone | 956-682-9894
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Fax | 956-682-9275
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS SERVICES
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Name | JERRY PENA
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Credential |
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Telephone | 956-682-9894
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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 | G4598
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License Number State | TX
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