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General NPI Number Information
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NPI Number | 1073160297
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Entity Type | Organization
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Legal Business Name | LONE STAR PEDIATRICS, PLLC
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 177 RIDGE ROAD
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City | MCKINNEY
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State | TX
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Zip | 75071
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Country | US
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Telephone | 469-591-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 177 RIDGE ROAD
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City | MCKINNEY
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State | TX
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Zip | 75071
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Country | US
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Telephone | 469-591-1900
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL H REYES
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Credential | MD
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Telephone | 469-591-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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