MEDICARE: WESTERN RADIATION ONCOLOGY ASSOCIATES, P.A.

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CJ4437	OTHER	TX	MEDICARE RAILROAD UPIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00U09E	OTHER	TX	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366557811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN RADIATION ONCOLOGY ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 203594
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-3594
Country	:	US
Telephone Number	:	281-517-0262
Fax Number	:	281-517-0263

Provider Business Practice Location Address
First Line	:	15500 SOUTHWEST FWY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3829
Country	:	US
Telephone Number	:	281-517-0262
Fax Number	:	281-517-0263

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	KATHERINE B KING
Credential	:
Telephone Number	:	281-517-0262

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	01/24/2012

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