Healthcare Provider Details

I. General information

NPI: 1689501280
Provider Name (Legal Business Name): LONESTAR MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5315 S 500 E SUITE A
WASHINGTON TERRACE UT
84405-4772
US

IV. Provider business mailing address

5315 S 500 E STE A
WASHINGTON TERRACE UT
84405-4772
US

V. Phone/Fax

Practice location:
  • Phone: 435-246-1814
  • Fax: 435-355-3705
Mailing address:
  • Phone: 435-246-1814
  • Fax: 435-355-3705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DAVID GARRETT JONES
Title or Position: PHYSICIAN ASSISTANT
Credential: DMSC, PA-C
Phone: 409-781-6143