Provider Demographics
NPI:1265710594
Name:NORTHPOINT RADIATION CENTER GP LLC
Entity type:Organization
Organization Name:NORTHPOINT RADIATION CENTER GP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-573-4611
Mailing Address - Street 1:PO BOX 678083
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8083
Mailing Address - Country:US
Mailing Address - Phone:512-583-0205
Mailing Address - Fax:512-583-2001
Practice Address - Street 1:7718 LOUIS PASTEUR CT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3442
Practice Address - Country:US
Practice Address - Phone:210-477-9060
Practice Address - Fax:210-477-9065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR06604261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX614451Medicare PIN