Provider Demographics
NPI:1922370733
Name:CANCER TREATMENT & PREVENTION CENTE
Entity type:Organization
Organization Name:CANCER TREATMENT & PREVENTION CENTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRIPTESH
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:CHAUDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-842-0003
Mailing Address - Street 1:4010 COLLEGE ST.
Mailing Address - Street 2:STE. 100
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-4016
Mailing Address - Country:US
Mailing Address - Phone:409-842-0003
Mailing Address - Fax:409-842-2031
Practice Address - Street 1:4010 COLLEGE ST.
Practice Address - Street 2:STE. 100
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-4016
Practice Address - Country:US
Practice Address - Phone:409-842-0003
Practice Address - Fax:409-842-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation TherapyGroup - Single Specialty