MEDICARE: LONE STAR SPINE AND INJURY CENTER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1184246985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONE STAR SPINE AND INJURY CENTER, PLLC

Provider Business Mailing Address
First Line	:	4301 RETAMA CIR
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-2768
Country	:	US
Telephone Number	:	361-360-3264
Fax Number	:	833-471-5910

Provider Business Practice Location Address
First Line	:	4301 RETAMA CIR
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-2768
Country	:	US
Telephone Number	:	361-360-3264
Fax Number	:	833-471-5910

Authorized Official
Title or Position	:	OWNER
Name	:	UMAR R MAHMOOD
Credential	:
Telephone Number	:	361-360-3264

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	02/19/2026

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