Organization
MISSOURI VEIN CARE, LLC
Active
Organization
MISSOURI VEIN CARE, LLC
Active
Other names
Heart, Lung, Circulation Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHEA THERESA MOSBY CPHT (EXECUTIVE ADMINISTRATIVE ASSISTANT)
(573) 632-2780
Entity
Organization
Contact information
Practice address
1620 SOUTHRIDGE DR STE B, JEFFERSON CITY, MO 65109-4005
(573) 632-2780
(573) 632-2784
Mailing address
1620 SOUTHRIDGE DR STE B, JEFFERSON CITY, MO 65109-4005
(573) 632-2780
(573) 632-2784
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50-6126507
—
MO
Enumeration date
06/28/2005
Last updated
07/10/2026
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