MEDICARE: CANCER CARE CENTERS OF SOUTH TEXAS

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
1	2085R0001X	Radiation Oncology Physician	E3811	TX
2	207RH0003X	Hematology & Oncology Physician	E3811	TX

General Provider Information

NPI Number	:	1336120054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANCER CARE CENTERS OF SOUTH TEXAS

Provider Business Mailing Address
First Line	:	4411 MEDICAL DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3832
Country	:	US
Telephone Number	:	210-595-5300
Fax Number	:	210-614-8740

Provider Business Practice Location Address
First Line	:	4411 MEDICAL DR, STE. 100
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3832
Country	:	US
Telephone Number	:	210-595-5300
Fax Number	:	210-614-8740

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROGER M. LYONS
Credential	:	MD
Telephone Number	:	210-595-5300

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	09/11/2025

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1982855813 — CANCER CARE NETWORK OF SOUTH TEXAS PA
Practice Location Address:

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1093817769 — MS. MARILYN LAIRD-GARLAND LCSW
Practice Location Address:

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Directions to “CANCER CARE CENTERS OF SOUTH TEXAS ” Practice Location

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