MEDICARE: GREATER HOUSTON RADIATION ONCOLOGY PA

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	207RH0003X	Hematology & Oncology Physician
2	2085R0001X	Radiation Oncology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871594424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER HOUSTON RADIATION ONCOLOGY PA

Provider Business Mailing Address
First Line	:	PO BOX 8399
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77387-8399
Country	:	US
Telephone Number	:	281-364-1707
Fax Number	:	281-364-0028

Provider Business Practice Location Address
First Line	:	25511 BUDDE RD STE 1201
Second Line	:	BELLE BUILDING
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-2091
Country	:	US
Telephone Number	:	281-364-1707
Fax Number	:	281-364-0028

Authorized Official
Title or Position	:	MEDICAL DIRECTOR PRESIDENT
Name	:	KIRK EDWARD KANADY
Credential	:	MD
Telephone Number	:	281-364-1704

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	08/10/2016

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