# RON MANSOLO MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Leander Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679574685
- **Authorized official:** JENNIFER G PASSONS (OFFICE MANAGER)
- **Authorized official phone:** (512) 968-7570

## Contact information

- **Practice address:** 902 CRYSTAL FALLS PKWY, LEANDER, TX 78641-3646
- **Practice address phone:** (512) 259-2222
- **Practice address fax:** (512) 259-2290
- **Mailing address:** 902 CRYSTAL FALLS PKWY, LEANDER, TX 78641-3646
- **Mailing address phone:** (512) 259-2222
- **Mailing address fax:** (512) 259-2290

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/02/2005
- **Last updated:** 03/09/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0039GH | BLUE CROSS BLUE SHIELD | TX |