Organization
AZLE NEUROMONITORING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUGUSTO CEZAR LASTIMOSA M.D. (MANAGING MEMBER)
(817) 908-8124
Entity
Organization
Contact information
Practice address
1244 BOLING RANCH ROAD N, AZLE, TX 76020
(817) 908-8124
(817) 885-7339
Mailing address
1244 BOLING RANCH ROAD N, AZLE, TX 76020
(817) 908-8124
(817) 885-7339
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
N8651
TX
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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