University Diagnostic And Treatment Clinic | |
12811 Beamer Rd Houston TX 77089-6140 | |
(713) 474-1414 | |
(713) 474-8477 |
Full Name | University Diagnostic And Treatment Clinic |
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Speciality | Clinic/Center |
Location | 12811 Beamer Rd, Houston, Texas |
Authorized Official Name and Position | Mark A Dandrea (OWNER) |
Authorized Official Contact | 7134741414 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
University Diagnostic And Treatment Clinic Po Box 7894 Pasadena TX 77508-7894 Ph: (713) 474-1414 | University Diagnostic And Treatment Clinic 12811 Beamer Rd Houston TX 77089-6140 Ph: (713) 474-1414 |
NPI Number | 1194723296 |
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Provider Enumeration Date | 07/12/2005 |
Last Update Date | 04/19/2016 |
Medicare PECOS PAC ID | 8426032897 |
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Medicare Enrollment ID | O20040614001570 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194723296 | NPI | - | NPPES |
149577201 | Medicaid | TX | |
0212DC | Other | TX | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
261QX0203X | Clinic/center - Oncology, Radiation | (* (Not Available)) | Primary |
Provider Name | Mark A Dandrea |
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Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1326081993 PECOS PAC ID: 8325022791 Enrollment ID: I20050609000727 |
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