MEDICARE: LONE STAR EVALUATIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1518109651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONE STAR EVALUATIONS

Provider Business Mailing Address
First Line	:	5151 KATY FWY STE 170
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-2261
Country	:	US
Telephone Number	:	713-802-0801
Fax Number	:	713-802-0105

Provider Business Practice Location Address
First Line	:	5151 KATY FWY STE 170
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-2261
Country	:	US
Telephone Number	:	713-802-0801
Fax Number	:	713-802-0105

Authorized Official
Title or Position	:	C.E.O.
Name	:	DR. JERRY M. MCSHANE
Credential	:	D.O.
Telephone Number	:	713-802-0801

Provider Enumeration Date	:	04/06/2009
Last Update Date	:	02/28/2014

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Directions to “LONE STAR EVALUATIONS ” Practice Location

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