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NPI Code Detail

MEDICARE: NORTHPOINT RADIATION CENTER GP LLC

MEDICARE: NORTHPOINT RADIATION CENTER GP LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1261QX0203XRadiation Oncology Clinic/CenterR06604TX

General Provider Information

NPI Number : 1265710594
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHPOINT RADIATION CENTER GP LLC
Provider Business Mailing Address
First Line : PO BOX 678083
Second Line :
City : DALLAS
State : TX
Zip : 75267-8083
Country : US
Telephone Number : 512-583-0205
Fax Number : 512-583-2001
Provider Business Practice Location Address
First Line : 7718 LOUIS PASTEUR CT
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3442
Country : US
Telephone Number : 210-477-9060
Fax Number : 210-477-9065
Authorized Official
Title or Position : CFO
Name : DAVE DICKEY
Credential :
Telephone Number : 972-573-4611
Provider Enumeration Date : 08/03/2011
Last Update Date : 08/03/2011

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