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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
2085R0205X
Radiological Physics Physician

Other

Enumeration date
12/02/2018
Last updated
12/02/2018
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