Organization
TEXAS VARICOSE VEIN CLINIC OF FORT WORTH, LLC
Active
Parent organization
TEXAS VARICOSE VEIN CLINIC, LLC
Other names
Gateway Vein & Leg Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEXAS VARICOSE VEIN CLINIC, LLC
Authorized official
MR. COREY T HOLTMAN (CEO)
(817) 698-8346
Entity
Organization
Contact information
Practice address
1106 ALSTON AVE, STE 200, FORT WORTH, TX 76104-4644
(817) 698-8346
(817) 698-9933
Mailing address
1106 ALSTON AVE, STE 200, FORT WORTH, TX 76104-4644
(817) 698-8346
(817) 698-9933
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
801678647
TX
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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