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GULF COAST CANCER & DIAGNOSTIC CENTER AT SOUTHEAST NPI 1194723296


NPI Information

NPI: 1194723296
Provider Name: GULF COAST CANCER & DIAGNOSTIC CENTER AT SOUTHEAST

Doing Business As: UNIVERSITY DIAGNOSTIC AND TREATMENT CLINIC

Classification: Clinic/Center - 261QX0203X
Entity Type: Organization

Specialization: Oncology, Radiation

Address:
12811 BEAMER RD
HOUSTON, TX
ZIP 77089
Phone: (713) 474-1414
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GULF COAST CANCER & DIAGNOSTIC CENTER AT SOUTHEAST is an oncology and radiation clinic center in Houston, TX. GULF COAST CANCER & DIAGNOSTIC CENTER AT SOUTHEAST NPI is 1194723296. The provider is registered as an organization entity type.
The provider Is Doing Business As University Diagnostic And Treatment Clinic.

The provider's business location address is:

12811 BEAMER RD
HOUSTON, TX
ZIP 77089-140
Phone: (713) 474-1414
Fax: (713) 474-8477

The provider's authorized official is Mark A Dandrea .
The authorized official title is Owner and has the following contact phone number (713) 474-1414.

The enumeration date for this NPI number is 7/12/2005 and was last updated on 4/19/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyNo
2261QX0203XClinic/CenterOncology, RadiationYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100328RMEDICARE PINTEXAS
2149577201MEDICAIDTEXAS
30212DCOTHERTEXASBLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.