MEDICARE: QUINTEN C. BLACK MD

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	V1032	TX
2	2085R0001X	Radiation Oncology Physician	2003-00747	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	134JJ	OTHER	NC	BCBS OF NC PROVIDER #
2	C8226	OTHER	NC	MEDCOST PROVIDER #
3	7685722	OTHER	NC	AETNA PROVIDER NUMBER
4	P00037555	OTHER	NC	RAILROAD MCARE PROV. #
5	0554569001	OTHER	NC	CIGNA PROVIDER NUMBER
6	1190946	OTHER	FL	GATEWAY HEALTH
7	36-00363	OTHER	NC	UTD. HLTHCR PROVIDER #
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578558474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUINTEN C. BLACK MD

Provider Business Mailing Address
First Line	:	PO BOX 911230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1230
Country	:	US
Telephone Number	:	972-997-8000
Fax Number	:	972-234-0813

Provider Business Practice Location Address
First Line	:	2121 PEASE ST STE 101
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8321
Country	:	US
Telephone Number	:	956-425-8845
Fax Number	:	956-364-6734

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	11/12/2025

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Directions to “ QUINTEN C. BLACK MD” Practice Location

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