Juventas Plasma LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L8483 Issued in TX

Legal business name

JUVENTAS PLASMA LLC

Practice address

1920 Corporate Drive
Suite 101 a
San Marcos, TX 78666

Phone

(512) 667-9247

NPI assigned

Mar 22, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Randolph, MD

Title

Owner

Phone

(512) 667-9247

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1558865717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 CORPORATE DRIVE",
            "address_2": "SUITE 101 A",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "78666",
            "telephone_number": "512-667-9247",
            "fax_number": "512-667-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 CORPORATE DRIVE",
            "address_2": "SUITE 101 A",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "78666",
            "telephone_number": "512-667-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUVENTAS PLASMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-667-9247",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyous Holdings Inc
• Megan Alyse Juarez, NP-C
• Julia B Symon MD
• Sara Julitz, SLP-CCC
• Elizabeth Renae Angstman Just, M.D.
• Mary Katherine Kaiser, MA, LPC, RPT
• Jason Aaron Karlik, ATC, LAT
• Ashley Keenan
• Savannah Nicole Keller
• Vanessa Kelly, M.S., CCC-SLP

• Family Medicine Physician in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.