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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
1905 S DONNYBROOK AVE, TYLER, TX 75701-4216
(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
10/01/2020
Last updated
10/01/2020
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