Provider Demographics
NPI:1861537730
Name:GREATER HOUSTON ONCOLOGY PA
Entity type:Organization
Organization Name:GREATER HOUSTON ONCOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TH
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-524-5030
Mailing Address - Street 1:3304 MILAM ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-3618
Mailing Address - Country:US
Mailing Address - Phone:713-524-5030
Mailing Address - Fax:713-524-4508
Practice Address - Street 1:3304 MILAM ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3618
Practice Address - Country:US
Practice Address - Phone:713-524-5030
Practice Address - Fax:713-524-4508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000000678ROtherBLUE SHIELD GRP BILLING N
TX1503757-1Medicaid
TX1503757-1Medicaid