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Organization
JUVENTAS PLASMA LLC
Active
Organization
JUVENTAS PLASMA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RANDOLPH MD (OWNER)
(512) 667-9247
Entity
Organization
Contact information
Practice address
1920 CORPORATE DRIVE, SUITE 101 A, SAN MARCOS, TX 78666
(512) 667-9247
Mailing address
1920 CORPORATE DRIVE, SUITE 101 A, SAN MARCOS, TX 78666
(512) 667-9247
(512) 667-7799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L8483
TX
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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