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General NPI Number Information
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NPI Number | 1568748580
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Entity Type | Organization
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Legal Business Name | LONESTAR THERAPY, LLC
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 1400 N WESTGATE DR SUITE 202
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City | WESLACO
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State | TX
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Zip | 78596-3996
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Country | US
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Telephone | 956-351-5289
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Fax | 956-351-5294
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Provider Business Mailing Address
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Address Line | PO BOX 1158
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City | WESLACO
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State | TX
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Zip | 78599-1158
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Country | US
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Telephone | 956-351-5289
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Fax | 956-351-5294
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Authorized Official
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Title or Position | SECRETARY
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Name | MS. CRISTINA ISABEL GARCIA
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Credential | LMSW-TEMP
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Telephone | 956-351-5289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | TX
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