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General NPI Number Information
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NPI Number | 1740464072
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Entity Type | Organization
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Legal Business Name | ROWLETT REGIONAL CANCER CENTER PA
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 7501 LAKEVIEW PKWY SUITE 100 - 120
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City | ROWLETT
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State | TX
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Zip | 75088
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Country | US
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Telephone | 972-475-4999
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Fax | 972-475-4422
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Provider Business Mailing Address
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Address Line | PO BOX 515308
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City | LOS ANGELES
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State | CA
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Zip | 90051-6608
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Country | US
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Telephone | 310-335-4056
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Fax | 310-335-4098
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Authorized Official
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Title or Position | CEO
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Name | ROBERT STEVEN BRADFIELD
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Credential | MD
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Telephone | 940-691-8271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State | TX
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Taxonomy #2
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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 | TX
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