Organization
TXIOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUGUSTO CEZAR LASTIMOSA M.D. (PRESIDENT)
(817) 908-8124
Entity
Organization
Contact information
Practice address
500 THROCKMORTON STREET, UNIT 3012, FORT WORTH, TX 76102
(817) 908-8124
Mailing address
500 THROCKMORTON STREET, UNIT 3012, FORT WORTH, TX 76102
(817) 908-8124
(817) 885-7339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F0555
TX
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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