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General NPI Number Information
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NPI Number | 1316753676
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Entity Type | Organization
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Legal Business Name | LONESTAR MED LAB LLC
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 18322 SONTERRA PL STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4196
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Country | US
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Telephone | 210-255-8588
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Fax |
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Provider Business Mailing Address
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Address Line | 18322 SONTERRA PL STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4196
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ROHIT B CHAUDHARY
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Credential |
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Telephone | 832-289-5775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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