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General NPI Number Information
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NPI Number | 1659002467
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Entity Type | Organization
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Legal Business Name | LONE STAR MEDLAB LABORATORY LLC
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 2120 W SPRING CREEK PKWY STE A-2
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City | PLANO
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State | TX
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Zip | 75023-4187
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Country | US
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Telephone | 469-969-0345
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Fax | 469-969-0346
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Provider Business Mailing Address
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Address Line | 2120 W SPRING CREEK PKWY STE A-2
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City | PLANO
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State | TX
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Zip | 75023-4187
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Country | US
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Telephone | 469-969-0345
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Fax | 469-969-0346
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SYED A HUSSAIN
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Credential | P.T
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Telephone | 224-461-2405
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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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