Individual
DR. AUGUSTO C.B. LASTIMOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 THROCKMORTON STREET, UNIT 3309, FORT WORTH, TX 76102
(817) 908-8124
(817) 885-7339
Mailing address
500 THROCKMORTON STREET, UNIT 3309, FORT WORTH, TX 76102
(817) 908-8124
(817) 885-7339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F0555
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1229353
—
TX
Enumeration date
06/23/2006
Last updated
03/30/2020
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