| Juventas Plasma Llc | |
|
1920 Corporate Drive Suite 101 A San Marcos TX 78666 | |
| (512) 667-9247 | |
| Not Available |
| Full Name | Juventas Plasma Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1920 Corporate Drive, San Marcos, Texas |
| Authorized Official Name and Position | Mark Randolph (OWNER) |
| Authorized Official Contact | 5126679247 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juventas Plasma Llc 1920 Corporate Drive Suite 101 A San Marcos TX 78666 Ph: (512) 667-9247 | Juventas Plasma Llc 1920 Corporate Drive Suite 101 A San Marcos TX 78666 Ph: (512) 667-9247 |
| NPI Number | 1558865717 |
|---|---|
| Provider Enumeration Date | 03/22/2018 |
| Last Update Date | 03/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558865717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L8483 (Texas) | Primary |
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