Organization
PALESTINE VASCULAR LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY ROTONDO (VP OF OPERATIONS)
(713) 539-7477
Entity
Organization
Contact information
Practice address
300 WILLOW CREEK PKWY STE 100, PALESTINE, TX 75801-4433
(903) 729-2888
(903) 729-2781
Mailing address
300 WILLOW CREEK PKWY STE 100, PALESTINE, TX 75801-4433
(903) 729-2888
(903) 729-2781
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
11/18/2019
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