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General NPI Number Information
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NPI Number | 1841490638
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Entity Type | Organization
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Legal Business Name | MAYHILL CANCER CENTER LLC
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 07/20/2007
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Provider Practice Location Address
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Address Line | 3537 SOUTH I - 35 SUITE 111
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City | DENTON
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State | TX
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Zip | 76210
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Country | US
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Telephone | 940-382-7830
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Fax | 940-382-8785
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Provider Business Mailing Address
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Address Line | 3537 SOUTH I - 35 SUITE 111
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City | DENTON
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State | TX
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Zip | 76210
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Country | US
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Telephone | 940-382-7830
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Fax | 940-382-8785
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MR. LAVELLE R HARDIN
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Credential |
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Telephone | 615-344-8203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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