Organization
ORTHOLONESTAR, PLLC
Active
Parent organization
ORTHOLONESTAR, PLLC
Other names
Azalea Orthopedics & Sports Medicine Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHOLONESTAR, PLLC
Authorized official
JENNIFER KINMAN (CEO)
(512) 439-1000
Entity
Organization
Contact information
Practice address
925 W LOOP 281, LONGVIEW, TX 75604-2918
(903) 939-7500
(903) 939-7728
Mailing address
3414 GOLDEN RD, TYLER, TX 75701-8336
(903) 939-7500
(903) 939-7728
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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