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General NPI Number Information
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NPI Number | 1447594809
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Entity Type | Organization
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Legal Business Name | LONESTAR HISTOLOGY, PLLC
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Dates
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Enumeration Date | 11/23/2012
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Last Update Date | 11/23/2012
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Provider Practice Location Address
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Address Line | 3418 MIDCOURT RD STE 101
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City | CARROLLTON
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State | TX
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Zip | 75006-4944
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Country | US
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Telephone | 469-546-5410
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Fax |
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Provider Business Mailing Address
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Address Line | 3418 MIDCOURT RD STE 101
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City | CARROLLTON
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State | TX
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Zip | 75006-4944
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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 | PRESIDENT
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Name | DR. PETER J NAUS
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Credential | M.D.
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Telephone | 469-546-5410
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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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