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General NPI Number Information
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NPI Number | 1770389371
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Entity Type | Organization
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Legal Business Name | LONE STAR IR LLC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 4510 MEDICAL CENTER DR STE 207
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City | MCKINNEY
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State | TX
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Zip | 75069-1602
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Country | US
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Telephone | 214-447-0821
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Fax |
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Provider Business Mailing Address
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Address Line | 3251 E STONEBROOK CIR
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City | DAVIE
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State | FL
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Zip | 33330-1293
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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 | AUTHORIZED OFFICIAL
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Name | SHIVANK BHATIA
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Credential | MD
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Telephone | 214-447-0821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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