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Organization
INNOVATIVE VASCULAR INSTITUTE, PLLC
Active
Organization
INNOVATIVE VASCULAR INSTITUTE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM D LONG MD (MEDICAL DIRECTOR)
(318) 792-6589
Entity
Organization
Contact information
Practice address
1010 NW LOOP 410 STE 100B, SAN ANTONIO, TX 78213-2220
(210) 465-7015
(210) 465-7014
Mailing address
1010 NW LOOP 410 STE 100B, SAN ANTONIO, TX 78213-2220
(210) 465-7015
(210) 465-7014
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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