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General NPI Number Information
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NPI Number | 1942837158
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS RADIATION ONCOLOGY PLLC
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 100B MEDICAL DR
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City | LAKE JACKSON
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State | TX
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Zip | 77566-5674
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Country | US
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Telephone | 979-297-9268
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Fax | 979-297-9331
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Provider Business Mailing Address
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Address Line | PO BOX 368
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City | LAKE JACKSON
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State | TX
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Zip | 77566-0368
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Country | US
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Telephone | 979-297-9268
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Fax | 979-297-9331
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Authorized Official
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Title or Position | RADIATION ONCOLOGY
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Name | DR. DANIEL RAY GARLITOS
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Credential | MD
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Telephone | 979-297-9268
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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 |
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License Number State |
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