Provider Demographics
NPI:1154371086
Name:TEXAS HEMATOLOGY / ONCOLOGY CENTER, P.A.
Entity type:Organization
Organization Name:TEXAS HEMATOLOGY / ONCOLOGY CENTER, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SABIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-247-5510
Mailing Address - Street 1:10 MEDICAL PKWY
Mailing Address - Street 2:PLAZA 3, STE#106
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7840
Mailing Address - Country:US
Mailing Address - Phone:972-247-5510
Mailing Address - Fax:972-488-7382
Practice Address - Street 1:4352 N JOSEY LN
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4602
Practice Address - Country:US
Practice Address - Phone:972-395-1010
Practice Address - Fax:972-395-5780
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS HEMATOLOGY/ONCOLOGY CENTER, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0367DCOtherBC/BS FACILITY PROVIDER NUMBER
0367DCOtherBC/BS FACILITY PROVIDER NUMBER
TX0083BYMedicare ID - Type Unspecified
DA0094Medicare PIN