Healthcare Provider Details

I. General information

NPI: 1457128837
Provider Name (Legal Business Name): LONE STAR MEDICAL ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 DORCHESTER DR
PLANO TX
75075-6443
US

IV. Provider business mailing address

1645 DORCHESTER DR STE A
PLANO TX
75075-6443
US

V. Phone/Fax

Practice location:
  • Phone: 972-777-6656
  • Fax:
Mailing address:
  • Phone: 469-777-6656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MUZAKEER AHMED SHAIK
Title or Position: OWNER
Credential: M.D
Phone: 480-235-1079