| Waco Regional Cancer Center | |
|
3420 Pine Ave Waco TX 76708-3130 | |
| (254) 752-2900 | |
| (254) 752-2902 |
| Full Name | Waco Regional Cancer Center |
|---|---|
| Speciality | Clinical Medical Laboratory |
| Location | 3420 Pine Ave, Waco, Texas |
| Authorized Official Name and Position | Baochong B Chang (PRESIDENT) |
| Authorized Official Contact | 2547522900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waco Regional Cancer Center 3420 Pine Ave Waco TX 76708-3130 Ph: (254) 752-2900 | Waco Regional Cancer Center 3420 Pine Ave Waco TX 76708-3130 Ph: (254) 752-2900 |
| NPI Number | 1003981341 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9335165091 |
|---|---|
| Medicare Enrollment ID | O20051021000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003981341 | NPI | - | NPPES |
| 1793838 | Medicaid | TX |
| Provider Name | Baochong B Chang |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790851525 PECOS PAC ID: 8325021652 Enrollment ID: I20040609000363 |
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