Provider Demographics
NPI:1871639179
Name:ROWLETT REGIONAL CANCER CENTER PA
Entity type:Organization
Organization Name:ROWLETT REGIONAL CANCER CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:BRADFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:574-315-8131
Mailing Address - Street 1:6300 BRIDGE POINT PKWY
Mailing Address - Street 2:BLDG 2 STE 115
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-5073
Mailing Address - Country:US
Mailing Address - Phone:512-583-2000
Mailing Address - Fax:512-583-2002
Practice Address - Street 1:9500 LAKEVIEW PKWY
Practice Address - Street 2:STE 200
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4557
Practice Address - Country:US
Practice Address - Phone:972-475-0960
Practice Address - Fax:972-412-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty