Provider Demographics
NPI:1861735771
Name:SPRINGMAN VEIN THERAPY CLINIC
Entity type:Organization
Organization Name:SPRINGMAN VEIN THERAPY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TRYKA
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CPMA
Authorized Official - Phone:956-546-3116
Mailing Address - Street 1:425 E LOS EBANOS BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8481
Mailing Address - Country:US
Mailing Address - Phone:956-574-0372
Mailing Address - Fax:956-574-0714
Practice Address - Street 1:425 E LOS EBANOS BLVD
Practice Address - Street 2:SUITE100
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8481
Practice Address - Country:US
Practice Address - Phone:956-546-3116
Practice Address - Fax:956-546-8793
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL ASSOCIATES OF BROWNSVILLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty