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General NPI Number Information
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NPI Number | 1629592530
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Entity Type | Organization
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Legal Business Name | LONE STAR MIND & BODY
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 3301 PLAINVIEW ST STE 1
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City | PASADENA
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State | TX
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Zip | 77504-1929
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Country | US
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Telephone | 832-451-2194
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 PLAINVIEW ST STE 1
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City | PASADENA
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State | TX
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Zip | 77504-1929
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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 | PARTNER
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Name | MR. ALFRED RAMIREZ
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Credential | RN, NP
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Telephone | 832-451-2194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State | TX
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