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NPI Code Detail

MEDICARE: HOUSTON NORTHWEST CANCER CENTER LP

MEDICARE: HOUSTON NORTHWEST CANCER CENTER LP
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
1207RX0202XMedical Oncology Physician
22085R0001XRadiation Oncology Physician

General Provider Information

NPI Number : 1710306675
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOUSTON NORTHWEST CANCER CENTER LP
Provider Business Mailing Address
First Line : 25511 BUDDE RD
Second Line : SUITE 1201
City : THE WOODLANDS
State : TX
Zip : 77380-2080
Country : US
Telephone Number : 281-364-1707
Fax Number : 281-364-0028
Provider Business Practice Location Address
First Line : 1140A CYPRESS STATION DR
Second Line :
City : HOUSTON
State : TX
Zip : 77090-3058
Country : US
Telephone Number : 281-377-7555
Fax Number : 281-364-0028
Authorized Official
Title or Position : DOCTOR
Name : DR. KIRK KANADY
Credential : MD
Telephone Number : 281-364-1707
Provider Enumeration Date : 04/08/2014
Last Update Date : 04/08/2014

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