Healthcare Provider Details
I. General information
NPI: 1982989463
Provider Name (Legal Business Name): LONESTAR PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2011
Last Update Date: 02/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1016 LA POSADA DR STE 285
AUSTIN TX
78752-3817
US
IV. Provider business mailing address
1016 LA POSADA DR STE 285
AUSTIN TEXAS
78752
UM
V. Phone/Fax
- Phone: 512-206-0808
- Fax: 512-206-0844
- Phone: 512-206-0808
- Fax: 512-206-0844
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
K
YUEN
Title or Position: OWNER
Credential: PHD
Phone: 512-206-0808