South Texas Radiation Oncology PLLC
in Lake Jackson, TX. Organization (NPI-2).
NPI number1962044628
StatusActive
Last updated in NPPESOct 15, 2019
Details
- NPI
- 1962044628
- Entity type
- Organization (NPI-2)
- Legal business name
- South Texas Radiation Oncology PLLC
- Organization subpart
- No
- Enumeration date
- Oct 15, 2019
- Last updated
- Oct 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0001X | – | – | Yes |
Practice location
100b Medical DrLake Jackson, TX 77566-5674
Phone 979-297-9268
Mailing address
100b Medical DrLake Jackson, TX 77566-5674
Phone 979-297-9268 · Fax 979-297-9331
Authorized official
Daniel Ray Garlitos
Owner
8325493961
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