Provider Demographics
NPI:1194079376
Name:CENTURY RADIATION ONCOLOGY LUBBOCK, PLLC
Entity type:Organization
Organization Name:CENTURY RADIATION ONCOLOGY LUBBOCK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-589-6879
Mailing Address - Street 1:424 N. UTICA
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-3035
Mailing Address - Country:US
Mailing Address - Phone:806-776-8200
Mailing Address - Fax:806-771-4177
Practice Address - Street 1:424 N. UTICA
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-3035
Practice Address - Country:US
Practice Address - Phone:806-776-8200
Practice Address - Fax:806-771-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-09
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty