Organization
RON MANSOLO MD PA
Active
Other names
Leander Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER G PASSONS (OFFICE MANAGER)
(512) 968-7570
Entity
Organization
Contact information
Practice address
902 CRYSTAL FALLS PKWY, LEANDER, TX 78641-3646
(512) 259-2222
(512) 259-2290
Mailing address
902 CRYSTAL FALLS PKWY, LEANDER, TX 78641-3646
(512) 259-2222
(512) 259-2290
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039GH
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/02/2005
Last updated
03/09/2011
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