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General NPI Number Information
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NPI Number | 1851851133
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Entity Type | Organization
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Legal Business Name | LONE STAR HEALTH CENTER LLC
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 11/22/2019
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Provider Practice Location Address
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Address Line | 2626 S LOOP W STE 320
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City | HOUSTON
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State | TX
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Zip | 77054-2649
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Country | US
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Telephone | 281-884-9989
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Fax | 281-688-4208
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Provider Business Mailing Address
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Address Line | 43 NORTH ST
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City | FOXBORO
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State | MA
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Zip | 02035-1353
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Country | US
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Telephone | 972-795-3422
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | AZIM NASIR
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Credential |
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Telephone | 972-795-3422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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