DFW COLON AND RECTAL SURGERY, PA
Radiology at Texas Health Trl, Keller, TX

License number
Texas L6097
Category
Radiology
Type
Surgery
Owner
Name: MS. DONNA S LONG
Title: OFFICE MANAGER
Phone: (817) 753-7029
Address
Address
10840 Texas Health Trl, Keller, TX 76244
National Provider ID: 1700931490
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DFW COLON AND RECTAL SURGERY, PA

Keller, TX  -  Fort Worth, TX

Industry:
Medical Doctor's Office
Registration:
Apr 18, 2006
Addresses:
10840 Texas Health Trl STE 200, Keller, TX 76244 (Mailing)
4375 Booth Calloway Rd, Fort Worth, TX 76180
State ID:
0800642682
Business type:
Professional Association
President, Director, Member:
Augustine J. Lee (President, Director, Member)
TIN:
32035192130

Dfw Colon & Rectal Surgery PA

10840 Texas Health Trl, Keller, TX 76244

Status:
Inactive
Industry:
General Hospital

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