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General NPI Number Information
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NPI Number | 1669306890
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Entity Type | Organization
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Legal Business Name | LONE STAR INTEGRATED ACUTE CARE OF EAST TEXAS PLLC
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 1204 N MOUND ST
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City | NACOGDOCHES
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State | TX
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Zip | 75961-4027
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Country | US
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Telephone | 936-564-4611
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Fax |
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Provider Business Mailing Address
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Address Line | 4535 DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-2545
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Country | US
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Telephone | 330-493-4443
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRANDON LEWIS
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Credential | DO
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Telephone | 330-493-4443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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