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General NPI Number Information
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NPI Number | 1922370733
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Entity Type | Organization
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Legal Business Name | CANCER TREATMENT & PREVENTION CENTE
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Dates
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Enumeration Date | 02/09/2012
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Last Update Date | 02/09/2012
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Provider Practice Location Address
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Address Line | 4010 COLLEGE ST. STE. 100
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City | BEAUMONT
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State | TX
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Zip | 77706-4016
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Country | US
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Telephone | 409-842-0003
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Fax | 409-842-2031
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Provider Business Mailing Address
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Address Line | 4010 COLLEGE ST. STE. 100
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City | BEAUMONT
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State | TX
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Zip | 77706-4016
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Country | US
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Telephone | 409-842-0003
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Fax | 409-842-2031
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | TRIPTESH KUMAR CHAUDHURY
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Credential | M.D.
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Telephone | 409-842-0003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471R0002X
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Taxonomy Name | Radiation Therapy Radiologic Technologist
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License Number |
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License Number State |
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