PHOENIX ONCOLOGY LOST PINES PLLC NPI 1558795161

NPI Information

  • NPI: 1558795161
  • Provider Name: PHOENIX ONCOLOGY LOST PINES PLLC
  • Classification: Radiology - 2085R0001X
  • Specialization: Radiation Oncology
  • Entity Type: Organization
  • Address: 3107 HIGHWAY 71 E
    BASTROP, TX
    ZIP 78602
  • Phone: (512) 303-5100

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NPI Details

PHOENIX ONCOLOGY LOST PINES PLLC is a radiation oncology radiology in Bastrop, TX. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. PHOENIX ONCOLOGY LOST PINES PLLC NPI is 1558795161. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3107 HIGHWAY 71 E
BASTROP, TX
ZIP 78602-158
Phone: (512) 303-5100
Fax: (512) 303-5106

The provider's authorized official is Jimmy Michael Kerley .
The authorized official title is Owner and has the following contact phone number (512) 303-5100.

The enumeration date for this NPI number is 8/30/2013 and was last updated on 8/30/2013.

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
12085R0001XRadiologyRadiation OncologyG3515TEXASYes

What is NPI?

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This page was last updated on: 11/21/2025

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