MEDICARE: TEXAS ONCOLOGY CARE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RH0003X	Hematology & Oncology Physician
2	207RX0202X	Medical Oncology Physician
3	2085R0001X	Radiation Oncology Physician
4	261QM1300X	Multi-Specialty Clinic/Center
5	261QX0203X	Radiation Oncology Clinic/Center
6	3336C0003X	Community/Retail Pharmacy
7	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	DN1807	OTHER	RR PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205863263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS ONCOLOGY CARE, PLLC

Provider Business Mailing Address
First Line	:	7415 LAS COLINAS BLVD
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7568
Country	:	US
Telephone Number	:	214-379-2737
Fax Number	:	214-379-2759

Provider Business Practice Location Address
First Line	:	7415 LAS COLINAS BLVD STE 100
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7569
Country	:	US
Telephone Number	:	214-379-2700
Fax Number	:	214-379-2750

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	CARMEN NIETO
Credential	:
Telephone Number	:	214-379-2731

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	11/24/2020

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