Healthcare Provider Details
I. General information
NPI: 1154515500
Provider Name (Legal Business Name): LONE STAR CIRCLE OF CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2007
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2423 WILLIAMS DR STE 107
GEORGETOWN TX
78628-3269
US
IV. Provider business mailing address
2423 WILLIAMS DR STE 107
GEORGETOWN TX
78628-3269
US
V. Phone/Fax
- Phone: 877-800-5722
- Fax: 512-551-0163
- Phone: 877-800-5722
- Fax: 512-551-0163
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
RHONDA
MUNDHENK
Title or Position: CEO
Credential:
Phone: 512-868-1124