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General NPI Number Information
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NPI Number | 1780639070
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Entity Type | Organization
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Legal Business Name | LONE STAR ORTHODONTICS, P.A.
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 7517 CAMERON RD STE #106
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City | AUSTIN
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State | TX
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Zip | 78752-2057
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Country | US
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Telephone | 512-278-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 8900 LONE TREE DR
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City | MANOR
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State | TX
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Zip | 78653-4843
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Country | US
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Telephone | 512-278-1111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DON RAYMOND HARTSFIELD
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Credential | D.D.S.
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Telephone | 512-278-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12117
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License Number State | TX
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