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General NPI Number Information
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NPI Number | 1639225550
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Entity Type | Organization
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Legal Business Name | LONE STAR CIRCLE OF CARE
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3102 MINTHORN DR
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City | KILLEEN
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State | TX
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Zip | 76542-1932
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Country | US
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Telephone | 254-268-1385
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Fax |
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Provider Business Mailing Address
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Address Line | 3102 MINTHORN DR
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City | KILLEEN
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State | TX
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Zip | 76542-1932
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Country | US
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Telephone | 254-268-1385
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Fax |
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Authorized Official
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Title or Position | OB CASE MANAGER
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Name | MRS. FERMINA AMARILIS ESPAILLAT
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Credential | RN
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Telephone | 512-828-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 628558
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License Number State | TX
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