Healthcare Provider Details

I. General information

NPI: 1699441071
Provider Name (Legal Business Name): LONESTAR PODIATRY & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 VILLAGE DR STE 300
MURPHY TX
75094-4634
US

IV. Provider business mailing address

412 VILLAGE DR STE 300
MURPHY TX
75094-4634
US

V. Phone/Fax

Practice location:
  • Phone: 415-216-3638
  • Fax:
Mailing address:
  • Phone: 972-643-8242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTIAN THARALE MORRISON
Title or Position: SURGEON/GROUP OWNER
Credential: DPM
Phone: 972-643-8242