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General NPI Number Information
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NPI Number | 1487843447
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Entity Type | Organization
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Legal Business Name | LONE STAR PEDIATRICS, PA
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 1011 W GROVE ST SUITE 100
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City | KAUFMAN
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State | TX
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Zip | 75142-1882
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Country | US
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Telephone | 972-932-1319
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Fax | 972-932-1388
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Provider Business Mailing Address
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Address Line | 1011 W GROVE ST SUITE 100
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City | KAUFMAN
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State | TX
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Zip | 75142-1882
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Country | US
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Telephone | 972-932-1319
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Fax | 972-932-1388
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES TURNER LEWIS III
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Credential | M.D.
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Telephone | 972-932-1319
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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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