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General NPI Number Information
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NPI Number | 1689062879
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Entity Type | Organization
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Legal Business Name | LONE MEDICAL MHT LLC
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | 1925 EDGEWATER DR
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City | PLANO
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State | TX
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Zip | 75075-8573
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Country | US
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Telephone | 972-423-8651
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 HERITAGE DR STE 110
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City | MCKINNEY
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State | TX
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Zip | 75069-3379
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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 | OWNER / PRESIDENT
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Name | DR. JAMAL LONE
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Credential | M.D.
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Telephone | 214-577-1824
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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 | M4304
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License Number State | TX
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