OrganizationActive
Colleyverse Iom, LLC
NPI 1013549278 · Surgical Technologist · Fort Worth, TX
Provider details
- NPI number
- 1013549278
- Entity type
- Organization
- Primary specialty
- Surgical TechnologistTechnologists, Technicians & Other Technical Service Providers
- Organization subpart
- No
- Authorized official
- Augusto Lastmosa, Managing Member(817) 366-4777
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
500 Throckmorton Street
Unit 3309
Fort Worth, TX 76102
Phone: (817) 908-8124
Fax: (817) 885-7339
Approximate (ZIP-level) locationGet directions
Mailing address
500 Throckmorton Street
Fort Worth, TX 76102
Registry dates
- Enumerated
- 2020-02-06
- Last updated
- 2020-02-06
- Certified
- 2020-02-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.