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General NPI Number Information
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NPI Number | 1750359519
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Entity Type | Organization
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Legal Business Name | CENTER FOR ONCOLOGY RESEARCH AND TREATMENT PA
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 7777 FOREST LANE SUITE B242
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City | DALLAS
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State | TX
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Zip | 75230
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Country | US
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Telephone | 972-566-5588
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Fax | 972-556-5587
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Provider Business Mailing Address
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Address Line | 7777 FOREST LANE SUITE B242
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City | DALLAS
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State | TX
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Zip | 75230
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Country | US
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Telephone | 972-566-5588
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Fax | 972-556-5587
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Authorized Official
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Title or Position | MD OWNER
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Name | BARRY C MIRTSCHING
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Credential | MD
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Telephone | 972-566-5588
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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 | H4558
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License Number State | TX
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