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Organization
INTERVENTIONAL AND VASCULAR CARE INC
Active
Organization
INTERVENTIONAL AND VASCULAR CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE RANDALL MARTIN CPA (CFO)
(817) 988-0986
Entity
Organization
Contact information
Practice address
12840 HILLCREST RD STE E104, DALLAS, TX 75230-1528
(214) 341-8770
Mailing address
PO BOX 92670, SOUTHLAKE, TX 76092-0670
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
2085R0205X
Radiological Physics Physician
—
NULL
2085R0205X
Radiological Physics Physician
—
—
Other
Enumeration date
12/02/2018
Last updated
12/02/2018
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